Systemic inflammation and survival of patients with prostate cancer: evidence from the Glasgow Inflammation Outcome Study

Shafique, K., Proctor, M.J., McMillan, D.C. , Qureshi, K., Leung, H. and Morrison, D.S. (2012) Systemic inflammation and survival of patients with prostate cancer: evidence from the Glasgow Inflammation Outcome Study. Prostate Cancer and Prostatic Diseases, 15(2), pp. 195-201. (doi:10.1038/pcan.2011.60)

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Publisher's URL: http://dx.doi.org/10.1038/pcan.2011.60

Abstract

<p><b>Background:</b> There is some evidence that systemic inflammation may be associated with survival in patients with prostate cancer; however, it is unclear whether this is independent of grade. We therefore investigated the role of inflammation-based prognostic scores, the modified Glasgow Prognostic Score (mGPS) and neutrophil lymphocyte ratio (NLR), and their associations with Gleason grade in patients with prostate cancer.</p> <p><b>Methods:</b> Patients from a cohort, the Glasgow Inflammation Outcome Study, who had diagnosis of prostate cancer, were included in this study. The mGPS was constructed by combining C-reactive protein and albumin whereas NLR by calculating the ratio of neutrophils to lymphocytes. We estimated 5-year relative survival and relative excess risk (RER) of death by mGPS and NLR categories after adjusting for age, socioeconomic circumstances and Gleason grade.</p> <p><b>Results:</b> In all, 897 prostate cancer patients were identified; of those 422 (47%) died during a maximum follow-up of 6.2 years. Systemic inflammation appeared to have significant prognostic value. The mGPS predicted poorer 5-year overall and relative survival independent of age, socioeconomic circumstances, disease grade and NLR. Raised mGPS also had a significant association with excess risk of death (mGPS 2: RER =2.41, 95% confidence interval 1.37–4.23) among aggressive, clinically significant prostate cancer (Gleason grades 8–10).</p> <p><b>Conclusions:</b> The mGPS is a strong measure of systemic inflammation, when compared with NLR. Prostate cancer patients with a raised mGPS had significantly higher risk of death for overall as well high-grade disease. Inflammation-based prognostic scores predict outcome in patients with prostate cancer and should be added to their routine clinical assessment.</p>

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Leung, Professor Hing and Morrison, Dr David and McMillan, Professor Donald
Authors: Shafique, K., Proctor, M.J., McMillan, D.C., Qureshi, K., Leung, H., and Morrison, D.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Clinical Specialities
College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Prostate Cancer and Prostatic Diseases
ISSN:1365-7852
ISSN (Online):1476-5608
Published Online:29 November 2011

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