Glasgow Prognostic Score is a Useful Predictive Factor for Palliative Surgery Outcomes in Advanced-stage Gastric Cancer

BACKGROUND/AIMS More than one million new gastric cancer cases have been reported in 2018. In many countries other than those in the Far East, gastric cancer could not be diagnosed at an early stage. Surgical options are limited in advanced-stage gastric cancer, and physicians have to make the right decision for the prolongation of patient survival. Surgery can prolong the survival even in advanced disease if the appropriate patient population is selected. The Glasgow prognostic score (GPS) was validated as a predictor of the prognosis in several cancer types. In this study, we aimed to test the hypothesis that GPS is useful to select the most suitable patients for surgical intervention in advanced-stage gastric cancer. MATERIAL and METHODS Data of 632 gastric cancer patients operated in our institute were investigated in this retrospective study. Eighty-four patients with gastric cancer who underwent palliative surgery and had complete clinical and follow-up data were included in this study. RESULTS Albumin levels were low in 46 patients. Forty-eight patients had high C-reactive protein (CRP) levels. Palliative gastrectomy was performed in 43 of 84 patients. Patients with a GPS of 2 survived a median 3 (95% confidence interval [CI]: 0.89-5.11) months, GPS of 1 for a median of 7 (95% CI: 4.50-9.50) months, and GPS of 0 for a median of 8 (95% CI: 3.31-12.70) months (p=0.047). Patients with modified GPS scores of 2 survived for a median of 3 (95% CI: 0.89-5.11) months, mGPS of 1 for a median of 3 (95% CI: 0.55-7.45) months, and mGPS of 0 for a median 8 (95% CI: 5.65-10.35) months (p=0.012). The mGPS values of patients with palliative gastric resection were compared; patients with mGPS of 0 had significantly longer survival times than those with mGPS 1 and 2. CONCLUSION The GPS and mGPS can be calculated prior to surgery using non-invasive and easily available laboratory tests. It has been shown in this study and other previous studies that mGPS can be particularly used easily to predict the prognosis in advanced-stage gastric cancer.