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Open Access Highly Accessed Research article

The modified Glasgow prognostic score in prostate cancer: results from a retrospective clinical series of 744 patients

Kashif Shafique12*, Michael J Proctor3, Donald C McMillan3, Hing Leung45, Karen Smith6, Billy Sloan7 and David S Morrison17

Author Affiliations

1 Institute of Health & Wellbeing, Public Health, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

2 Department of Community Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan

3 University Department of Surgery, Faculty of Medicine, University of Glasgow, Royal Infirmary, Glasgow G31 2ER, UK

4 Urology Department, Gartnavel General Hospital, 1053 Great Western Road, Glasgow G12 0YN, UK

5 Beatson Institute for Cancer Research, Garscube Estate Switchback Road Bearsden, Glasgow G61 1BD, UK

6 Department of Clinical Biochemistry, Royal Infirmary, Glasgow G4 0SF, UK

7 West of Scotland Cancer Surveillance Unit, University of Glasgow, 1 Lilybank Gardens, Glasgow G12 8RZ, UK

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BMC Cancer 2013, 13:292  doi:10.1186/1471-2407-13-292

Published: 17 June 2013

Abstract

Background

As the incidence of prostate cancer continues to rise steeply, there is an increasing need to identify more accurate prognostic markers for the disease. There is some evidence that a higher modified Glasgow Prognostic Score (mGPS) may be associated with poorer survival in patients with prostate cancer but it is not known whether this is independent of other established prognostic factors. Therefore the aim of this study was to describe the relationship between mGPS and survival in patients with prostate cancer after adjustment for other prognostic factors.

Methods

Retrospective clinical series on patients in Glasgow, Scotland, for whom data from the Scottish Cancer Registry, including Gleason score, Prostate Specific Antigen (PSA), C-reactive protein (CRP) and albumin, six months prior to or following the diagnosis, were included in this study.

The mGPS was constructed by combining CRP and albumin. Five-year and ten-year relative survival and relative excess risk of death were estimated by mGPS categories after adjusting for age, socioeconomic circumstances, Gleason score, PSA and previous in-patient bed days.

Results

Seven hundred and forty four prostate cancer patients were identified; of these, 497 (66.8%) died during a maximum follow up of 11.9 years. Patients with mGPS of 2 had poorest 5-year and 10-year relative survival, of 32.6% and 18.8%, respectively. Raised mGPS also had a significant association with excess risk of death at five years (mGPS 2: Relative Excess Risk = 3.57, 95% CI 2.31-5.52) and ten years (mGPS 2: Relative Excess Risk = 3.42, 95% CI 2.25-5.21) after adjusting for age, socioeconomic circumstances, Gleason score, PSA and previous in-patient bed days.

Conclusions

The mGPS is an independent and objective prognostic indicator for survival of patients with prostate cancer. It may be useful in determining the clinical management of patients with prostate cancer in addition to established prognostic markers.

Keywords:
mGPS; Prostate cancer; Prognosis; PSA