Significance of the Inflammation-Based Glasgow Prognostic Score for Short- and Long-Term Outcomes After Curative Resection of Gastric Cancer

Background

The Glasgow prognostic score (GPS) is a patient-related measure to determine long-term outcomes in cancer patients. This study examined the impact of GPS on outcomes including postoperative complications after curative resection of gastric cancer.

Methods

The systemic inflammatory response was assessed by GPS, and the severity of postoperative complications was evaluated according to the Clavien?CDindo classification. Survival analysis was performed by the Kaplan?CMeier method and the log rank test. Multivariate analysis was performed to determine significant associations with complications by a logistic regression model and the independent prognostic values by Cox??s proportional hazards model.

Results

Study patients (n?=?1017) were allocated as follows: 904 (88.9?%) to GPS 0, 92 (9.0?%) to GPS 1, and 21 (2.1?%) to GPS 2. One hundred sixty-three patients (16.0?%) had postoperative complications of ?? grade 2. Multivariate logistic analysis identified gender, body mass index, tumor location, tumor depth, blood transfusion, and comorbidity as significantly correlated with postoperative complications. However, GPS was not associated with the incidence of complication. On the other hand, multivariate analysis for overall survival identified GPS as an independent prognostic factor.

Conclusions

GPS is a significant predictor of long-term survival in curable gastric cancer surgery but not of short-term outcomes.