The glasgow prognostic score as a predictor of survival in patients with potentially resectable pancreatic adenocarcinoma

Ann Surg Oncol. 2012 Sep;19(9):2917-23. doi: 10.1245/s10434-012-2348-9. Epub 2012 Apr 10.


Background: Survival rates after resection of pancreatic adenocarcinoma are poor; however, several tumor-related prognostic factors have been identified. There is increasing evidence that additional patient-related prognostic factors, such as ongoing systemic inflammatory response, are associated with poor outcomes in patients with common solid tumors. The purpose of this study was to evaluate the prognostic significance of the modified glasgow prognostic score (mGPS) in resected pancreatic ductal adenocarcinoma.

Methods: Data were collected from 101 patients who had undergone pancreatic resection for ductal adenocarcinoma. Tumor and host factors were analyzed by Kaplan-Meier and Cox proportional hazard models to evaluate their potential prognostic effects.

Results: An elevated mGPS was associated with lower overall survival rate after pancreatic resection. The median actuarial survival rate for patients with an mGPS of 0, 1, or 2 was 37.2, 11.5, and 7.3, respectively (p = 0.0001). The Cox proportional hazards model, including all the parameters statistically significant at univariate analysis, demonstrated that mGPS, lymph node ratio (LNR), and positive resection margins were independent negative prognostic factors

Conclusions: Margin involvement, LNR, and the preoperative mGPS were identified as independent predictors of survival in patients undergoing potentially curative pancreatic resection. Based on the present results and existing validation literature, the mGPS should be included in the routine assessment of patients with pancreatic cancer to better stratify patients for entry into therapeutic trials.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / blood*
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery
  • Aged
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Inflammation / blood
  • Kaplan-Meier Estimate
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neoplasm, Residual
  • Pancreatic Neoplasms / blood*
  • Pancreatic Neoplasms / pathology*
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy
  • Prognosis
  • Proportional Hazards Models
  • Serum Albumin / metabolism*
  • Survival Rate


  • Serum Albumin
  • C-Reactive Protein