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, 2020, 8736509
eCollection

The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

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The Prognostic Role of Glasgow Prognostic Score and C-reactive Protein to Albumin Ratio for Sarcoma: A System Review and Meta-Analysis

Erhu Fang et al. Dis Markers.

Abstract

Backgrounds: Both pretreatment serum CRP (C-reactive protein) level and ALB (albumin) level have been found to be predictive of survival for multiple malignancies including sarcoma. Since both of the GPS (Glasgow prognostic score) and CAR (C-reactive protein to albumin ratio) are based on the combination of CRP and ALB, we conducted a meta-analysis to evaluate the prognostic role of these two parameters for sarcoma patients.

Methods: A detailed literature search was conducted in MEDLINE, Embase, and Cochrane Library for relevant research publications written in English. Patients' clinical characteristics, outcomes of overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS) were extracted. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were combined to evaluate the prognostic role of GPS or CAR.

Results: Twelve articles containing 2695 patients were identified as eligible studies. The results showed that an elevated GPS was significantly correlated with poor OS (HR = 2.42; 95% CI: 1.98-2.94; p < 0.001; fixed-effects model), DSS (HR = 2.28; 95% CI: 1.75-2.97; p < 0.001; fixed-effects model), DSS (HR = 2.28; 95% CI: 1.75-2.97; p < 0.001; fixed-effects model), DSS (HR = 2.28; 95% CI: 1.75-2.97; p < 0.001; fixed-effects model), DSS (HR = 2.28; 95% CI: 1.75-2.97; p < 0.001; fixed-effects model), DSS (HR = 2.28; 95% CI: 1.75-2.97.

Conclusion: An elevated GPS is predictive of poor survival in patients with sarcomas and is promising to be used as a factor for risk stratification. A higher CAR value is also predictive of poor survival; however, the optimal CAR cut-off value is still to be determined.

Conflict of interest statement

The authors declare that there is no conflict of interest regarding the publication of this paper.

Figures

Figure 1
Figure 1
PRISMA flowchart presenting the steps of record search and selection.
Figure 2
Figure 2
The forest plot about the association between elevated GPS and OS. The pooled effect was calculated using a fixed-effects model.
Figure 3
Figure 3
The plot of sensitivity analysis showing the influence of each one of the included study.
Figure 4
Figure 4
Forest plot showing the association between elevated GPS and DSS in patients with sarcoma. The pooled effect was calculated using a fixed-effects model.
Figure 5
Figure 5
Forest plot showing the association between elevated GPS and DFS in patients with sarcoma. The pooled effect was calculated using a fixed-effects model.
Figure 6
Figure 6
Forest plot showing the association between elevated CAR and OS in patients with sarcoma. The pooled effect was calculated using a fixed-effects model.
Figure 7
Figure 7
Forest plot showing the association between elevated CAR and DFS in patients with sarcoma. The pooled effect was calculated using a fixed-effects model.
Figure 8
Figure 8
Analysis of publication bias. (a) Begg's funnel plot about the association between GPS and OS. (b) Begg's funnel plot about the association between GPS and DSS. (c) Begg's funnel plot about the association between GPS and DFS. (d) Begg's funnel plot about the association between CAR and OS.

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