Rocha, B. M.M., Dolan, R. D. , Paiva, C. E., McGovern, J., Paiva, B. S. R., Preto, D. D., McMillan, D. C. , Maia, Y. C. P. and Laird, B. J. (2023) Inflammation and performance status: the cornerstones of prognosis in advanced cancer. Journal of Pain and Symptom Management, 65(4), pp. 348-357. (doi: 10.1016/j.jpainsymman.2022.11.021) (PMID:36493981)
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Abstract
Context: In advanced cancer, although performance status (PS), systemic inflammatory response and nutritional status are known to have prognostic value, geographical variations and sociodemographic indexes may also impact survival. Objectives: This study compares validated prognostic factors in two international cohorts and establishes a prognostic framework for treatment. Methods: Two international biobanks of patients (n=1.518) with advanced cancer were analyzed. Prognostic factors (Eastern Cooperative Oncology Group Performance Status [ECOG-PS], body mass index [BMI] and modified Glasgow Prognostic Score [mGPS]) were assessed. The relationship between these and survival was examined using Kaplan–Meier and Cox regression methods. Results: According to multivariate analysis, in the European cohort the most highly predictive factors were BMI <20 kg/m2 (hazard ratio [HR] 1.644), BMI 20-21.9 kg/m2 (HR 1.347), ECOG-PS (HR 1.597–11.992) and mGPS (HR 1.843–2.365). In the Brazilian cohort, the most highly predictive factors were ECOG-PS (HR 1.678–8.938) and mGPS (HR 2.103–2.837). Considering gastrointestinal cancers in particular (n=551), the survival rate at 3 months in both cohorts together ranged from 93% (mGPS 0, PS 0–1) to 0% (mGPS 2, PS 4), and from 81% (mGPS 0, BMI >28 kg/m2) to 44% (mGPS 2, BMI <20 kg/m2). Conclusion: The established prognostic factors that were compared had similar prognostic capacity in both cohorts. A high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer survival of patients with advanced cancer in the prospective European and Brazilian cohorts.
| Item Type: | Articles |
|---|---|
| Keywords: | Advanced cancer, inflammation, performance status, prognosis, survival analysis. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Dolan, Dr Ross and McMillan, Professor Donald and McGovern, Mr Josh |
| Authors: | Rocha, B. M.M., Dolan, R. D., Paiva, C. E., McGovern, J., Paiva, B. S. R., Preto, D. D., McMillan, D. C., Maia, Y. C. P., and Laird, B. J. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
| Journal Name: | Journal of Pain and Symptom Management |
| Publisher: | Elsevier |
| ISSN: | 0885-3924 |
| ISSN (Online): | 1873-6513 |
| Published Online: | 06 December 2022 |
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