Prognostic Significance of Glasgow prognostic score in patients undergoing esophagectomy for esophageal squamous cell carcinoma

Background/Aims: Recent studies have revealed that Glasgow prognostic score (GPS), an inflammation-based prognostic score, is inversely related to prognosis in a variety of cancers; high levels of GPS is associated with poor prognosis. However, few studies regarding GPS in esophageal cancer (EC) are available. The aim of this study was to determine whether the GPS is useful for predicting cancer-specific survival (CSS) of patients for esophageal squamous cell carcinoma (ESCC). Patients and Methods: The GPS was calculated on the basis of admission data as follows: Patients with elevated C-reactive protein (CRP) level (> 10 mg/L) and hypoalbuminemia (< 35 g/L) were assigned to GPS2. Patients with one or no abnormal value were assigned to GPS1 or GPS0, respectively. Results: Our study showed that GPS was associated with tumor size, depth of invasion, and nodal metastasis (P < 0.001). In addition, there was a negative correlation between the serum CRP and albumin (r = 0.412, P < 0.001). The 5-year CSS in patients with GPS0, GPS1, and GPS2 were 60.8%, 34.7% and 10.7%, respectively (P < 0.001). Multivariate analysis showed that GPS was a significant predictor of CSS. GPS1-2 had a hazard ratio (HR) of 2.399 [95% confidence interval (CI): 1.805-3.190] for 1-year CSS (P < 0.001) and 1.907 (95% CI: 1.608-2.262) for 5-year CSS (P < 0.001). Conclusion: High levels of GPS is associated with tumor progression. GPS can be considered as an independent prognostic factor in patients who underwent esophagectomy for ESCC.