Glasgow Prognostic Score (GPS) for Cancer Outcomes
Patients with known cancer.
- The Glasgow Prognostic Score (GPS) has been evaluated across numerous different cancer cohorts and suggests incrementally worsening prognosis with increasing score.
- Depending upon patient selection, stage, cancer and other factors the resulting survival numbers vary widely.
- The modified GPS uses the same parameters as the original GPS (CRP and albumin), but weighs the inflammatory component more heavily; i.e., patients with low albumin are still assigned a score of 0 even if CRP is elevated. The modified GPS was shown to have better correlation with survival (in colon and rectal cancer from the original paper, and in other cancers from the validation papers).
Multiple studies suggest significantly worse outcome in multiple types of cancer, including “increased weight loss, poor performance status, increased comorbidity, increased pro-inflammatory and angiogenic cytokines and complications on treatment.” (McMillan DC 2013)
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The Glasgow Prognosis Score (GPS) helps stratify prognosis groups and may be a worthy addition to multifactorial evaluations.
We are unaware of validated management algorithms using the GPS.
The GPS requires serum laboratory values and may be relevant when drawn prior to or after cancer diagnosis.
Selection of appropriate criteria.
Facts & Figures
The GPS has been shown to be accurate in different types of cancer, including cervical, renal, lung, gastric cancers, as well as in primary care. However, the score has been modified with better predictive values.
Original/Primary ReferenceForrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Evaluation of cumulative prognostic scores based on the systemic inflammatory response in patients with inoperable non-small-cell lung cancer. British Journal of Cancer. 2003;89(6):1028-1030. doi:10.1038/sj.bjc.6601242.
ValidationRoxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer. Future Oncol. 2010 Jan;6(1):149-63. doi: 10.2217/fon.09.136.Proctor MJ, Talwar D, Balmar SM, et al. The relationship between the presence and site of cancer, an inflammation-based prognostic score and biochemical parameters. Initial results of the Glasgow Inflammation Outcome Study. British Journal of Cancer. 2010;103(6):870-876. doi:10.1038/sj.bjc.6605855.
Other ReferencesForrest LM, McMillan DC, McArdle CS, Angerson WJ, Dunlop DJ. Comparison of an inflammation-based prognostic score (GPS) with performance status (ECOG) in patients receiving platinum-based chemotherapy for inoperable non-small-cell lung cancer. British Journal of Cancer. 2004;90(9):1704-1706. doi:10.1038/sj.bjc.6601789.McMillan DC et. al. Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer. Int J Colorectal Dis. 2007 Aug;22(8):881-6. Epub 2007 Jan 24.
About the Creator
Donald McMillan, MD, is a professor of surgical science at the University of Glasgow and an associate academic at the Institute of Cancer Sciences. His research focuses on systemic inflammatory response in weight loss and poor physical function, quality of life and survival of cancer patients.
To view Dr. Donald McMillan's publications, visit PubMed