Prognostic value of modified Glasgow prognostic score in recurrent high-grade glial tumors treated with systemic treatment

Clin Neurol Neurosurg. 2020 Sep:196:105976. doi: 10.1016/j.clineuro.2020.105976. Epub 2020 May 30.

Abstract

Objectives: Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor. We aimed to evaluate the prognostic value of modified Glasgow Prognostic Score (mGPS), which is combination of C-reactive protein (CRP) and albumin, in recurrent high-grade glioma patients treated with systemic treatment.

Patients and methods: Data of 85 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 was retrospectively collected and analyzed. Patients were grouped according to mGPS criteria: mGPS-0: CRP < 10 mg/L and albumin >3.5 g/dL; mGPS-1: CRP < 10 mg/L and albumin <3.5 g/dL or CRP > 10 mg/L and albumin >3.5 g/dL; and mGPS-2: CRP > 10 mg/L and albumin <3.5 mg/L. We investigated the prognostic role of mGPS groups, mutations and survival outcomes.

Results: There were 42 (49.4 %), 25 (29.6 %), and 18 (21 %) patients in mGPS-0, mGPS-1, and mGPS-2 groups, respectively. Median follow-up duration was 10 months (1-70 months). Median OS was 8.1 months. According to mGPS-0, -1 and -2; median OS was 13.8 months, 7.3 months and 3.6 months respectively (p = 0.003). mGPS, ATRX and IDH-1 mutation status, and ECOG PS were found to be independent prognostic factors for OS.

Conclusion: In our study, mGPS was found to be an independent prognostic factor in patients with recurrent high-grade gliomas. If validated, mGPS can be used as an objective, easily calculated, cheap, and readily available prognostic model in routine practice.

Keywords: ATRX status; Glasgow prognostic score; glioblastoma; high grade gliomas; overall survival.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Neoplasms / blood
  • Brain Neoplasms / genetics
  • Brain Neoplasms / mortality*
  • Brain Neoplasms / therapy
  • C-Reactive Protein / analysis*
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Glioblastoma / blood
  • Glioblastoma / genetics
  • Glioblastoma / mortality*
  • Glioblastoma / therapy
  • Humans
  • Inflammation
  • Isocitrate Dehydrogenase / genetics
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Proteins / genetics
  • Neoplasm Recurrence, Local / blood
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / mortality*
  • Neoplasm Recurrence, Local / radiotherapy
  • Neurosurgical Procedures*
  • Prognosis
  • Progression-Free Survival
  • Proportional Hazards Models
  • Radiosurgery
  • Radiotherapy, Conformal
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin, Human / analysis*
  • Severity of Illness Index*
  • X-linked Nuclear Protein / genetics
  • Young Adult

Substances

  • Neoplasm Proteins
  • C-Reactive Protein
  • Isocitrate Dehydrogenase
  • IDH1 protein, human
  • ATRX protein, human
  • X-linked Nuclear Protein
  • Serum Albumin, Human