The prognostic value of pretreatment Glasgow Prognostic Score in patients with esophageal cancer: a meta-analysis

Objectives: To examine the predictive role of Glasgow Prognostic Score (GPS) on long-term survival in esophageal cancer. Method: Comprehensive searches of electronic databases were performed to identify potential studies that evaluated the prognostic value of pretreatment GPS in esophageal cancer patients. We combined the hazard ratios (HRs) with 95% confidence intervals (CIs) to assess the association of GPS with overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). Results: A total of 21 studies including 6115 patients were analyzed. Compared with patients with GPS 0, patients with elevated GPS had poorer OS (HR =2.12, 95% CI: 1.83-2.45, P<0.001) and CSS (HR =2.16, 95% CI: 1.56-2.98, P<0.001); but no significant relationship was observed between the elevated GPS and DFS (HR=2.14, 95% CI:1.00-4.61, P=0.051). Subgroup analysis outcomes were similar to overall analyses. Conclusion: Pretreatment GPS could serve as a valuable factor in predicting the prognosis of patients with esophageal cancer. More well-designed prospective studies are warranted to confirm our findings.