Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Modified Glasgow Prognostic Score (mGPS) for Cancer Outcomes

    Provides improved cancer prognosis over the original score, based on serum biomarkers.
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    INSTRUCTIONS

    We recommend this modified version of the score over the original GPS.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with known cancer.

    • The Modified Glasgow Prognostic Score (mGPS) 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. This modification 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)

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

    The Modified Glasgow Prognosis Score helps stratify prognosis groups and may be a worthy addition to multifactorial evaluations. As a stand-alone in individual cases it is unclear at this point how accurate it is likely to be.

    Management

    We are unaware of validated management algorithms using the mGPS.

    Critical Actions

    The modified GPS does not assign a point for low albumin as a singular finding, which is different from the original GPS. The c-reactive protein value must be elevated for points to be assigned.

    Formula

    Selection of appropriate criteria.

    Facts & Figures

    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. This modification 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).

    The mGPS has been shown to be accurate in different types of cancer, including renal, lung, gastric cancers, as well as in primary care. The predictive values are listed below for each type of cancer.

    Type of cancer mGPS Median Survival
    Gastric 0 5 year Overall Survival: 74.6%
    1 5 year Overall Survival: 61.4%
    2 5 year Overall Survival: 34.6%
    Renal 0 1 year RFS: 90.9%
    1 1 year RFS: 61.1%
    2 1 year RFS: 10.1%
    Lung (Small Cell) 0 3 Month Survival: 99%
    2 3 Month Survival: 71%

    Evidence Appraisal

    mgps pi diagram

    Literature

    Dr. Michael J. Proctor

    About the Creator

    Michael J. Proctor, MD, is a faculty member at the University of Glasgow and practices at the Royal Infirmary. His research focuses on systemic inflammatory response in weight loss, poor physical function and quality of life and poor survival of the patient with cancer.

    To view Dr. Michael J. Proctor's publications, visit PubMed