scholarly journals Clinical utility of the Glasgow Prognostic Score in patients undergoing curative nephrectomy for renal clear cell cancer: basis of new prognostic scoring systems

2011 ◽  
Vol 106 (2) ◽  
pp. 279-283 ◽  
Author(s):  
G W A Lamb ◽  
M Aitchison ◽  
S Ramsey ◽  
S L Housley ◽  
D C McMillan
2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
David G. Watt ◽  
Campbell S. Roxburgh ◽  
Mark White ◽  
Juen Zhik Chan ◽  
Paul G. Horgan ◽  
...  

Introduction.The systemic inflammatory response (SIR) plays a key role in determining nutritional status and survival of patients with cancer. A number of objective scoring systems have been shown to have prognostic value; however, their application in routine clinical practice is not clear. The aim of the present survey was to examine the range of opinions internationally on the routine use of these scoring systems.Methods.An online survey was distributed to a target group consisting of individuals worldwide who have reported an interest in systemic inflammation in patients with cancer.Results.Of those invited by the survey (n=238), 65% routinely measured the SIR, mainly for research and prognostication purposes and clinically for allocation of adjuvant therapy or palliative chemotherapy. 40% reported that they currently used the Glasgow Prognostic Score/modified Glasgow Prognostic Score (GPS/mGPS) and 81% reported that a measure of systemic inflammation should be incorporated into clinical guidelines, such as the definition of cachexia.Conclusions.The majority of respondents routinely measured the SIR in patients with cancer, mainly using the GPS/mGPS for research and prognostication purposes. The majority reported that a measure of the SIR should be adopted into clinical guidelines.


2020 ◽  
Vol 24 (5) ◽  
pp. 58-63
Author(s):  
A. M. Mambetova ◽  
M. H. Hutueva ◽  
I. K. Thabisimova ◽  
A. S. Kegaduyev

BACKGROUND. The role of inflammation and uremic intoxication in the development and progression of bone mineral dis­orders, including cardiovascular calcification, has been actively studied over the past decades. PATIENTS AND METHODS. A single-stage, cohort study of 85 patients with stage 5D CKD treated with programmatic hemodialysis was conducted. The blood concentrations of interleukin-3 (IL-3) and interleukin-6 (IL-6) were determined using the enzyme immunoassay, the level of fibrinogen - using the Rutberg method, and the level of p2-microglobulins - using the nephelometric method. The blood leu­kocyte shift index (ISLC) and the Glasgow Prognostic Score (GPS) risk index for systemic inflammation were also calculated, taking into account the level of C-reactive protein (CRP) and blood albumin. The presence of valvular calcification, its severity, and calcification of the abdominal aortic wall was recorded. Statistical analysis was performed using the program STATISTICA 12.6 ("StatSoft", USA). THE AIM: to evaluate the relationship between factors of systemic inflammation and cardiovascular cal­cification in patients with stage 5D chronic kidney disease. RESULTS. The risk of detecting calcification of the aorta and heart valves was influenced by the pro-inflammatory cytokines IL-3 and IL-6, as well as ISLK and GPS. However, inflammatory fac­tors such as fibrinogen, p2-microglobulin, and CRP levels in the blood did not show a statistically significant effect. In the case when the predicted parameter was chosen not friendly calcification, but the presence of any of its components, the predictive significance of IL-3 decreased, but IL-6 remained. The 20% risk threshold was exceeded at IL-6 values of more than 33 pg/ml. The effect of ISLC on the probability of detection of calcification was shown both about friendly calcification and concerning isolated calcification of the aorta or valves. CONCLUSION. It was found that among the studied factors of inflammation, IL-6, ILK, and IL-3 demonstrate a relationship with the processes of cardiovascular calcification, GPS-only in relation to friendly calcification. Nomograms have been developed that allow predicting the detection of cardiovascular calcification in dialysis patients, depending on the state of the inflammatory circuit.


2015 ◽  
Vol 25 (7) ◽  
pp. 1306-1314 ◽  
Author(s):  
Takeshi Nishida ◽  
Keiichiro Nakamura ◽  
Junko Haraga ◽  
Chikako Ogawa ◽  
Tomoyuki Kusumoto ◽  
...  

ObjectiveThe Glasgow prognostic score (GPS) determined at pretreatment is important in the prediction of prognosis in various cancers. We investigated if the GPS used both at pretreatment and during concurrent chemoradiotherapy (CCRT) could predict the prognosis of patients with cervical cancer.MethodsWe collected GPS and clinicopathological data from the medical records of 91 patients who underwent CCRT for cervical cancer; their GPSs at pretreatment and during CCRT were retrospectively analyzed for correlations with recurrence and survival. Statistical analyses were performed using the Mann-WhitneyUtest. Disease-free survival (DFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Cox’s proportional hazard regression was used for univariate and multivariate analyses.ResultsThe median follow-up for all patients who were alive at the time of last follow-up was 38.0 months (range, 1–108 months). The DFS and OS rates of patients with a high GPS during CCRT (GPS 1 + 2; 55 patients; 60.4%) were significantly shorter than those for patients with a low GPS (GPS 0; 36 patients; 39.6%) (DFS,P< 0.001; OS,P< 0.001). Furthermore, multivariate analyses showed that high GPS during CCRT was an independent prognostic factor of survival for OS (P= 0.008).ConclusionsDuring CCRT, a high GPS was revealed to be an important predictor of survival for cervical cancer.


Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Khawaja Ammar ◽  
Todd D Miller ◽  
David O Hodge ◽  
Richard J Rodeheffer ◽  
Raymond J Gibbons

Background : Unrecognized myocardial infarction (UMI), as diagnosed by surveillance electrocardiography (ECG), has the same poor prognosis as recognized (RMI), independent of ejection fraction or ischemia. The value of post UMI risk stratification by infarct size is unknown. Methods : The study group consisted of 5430 patients who underwent 2 day stress (exercise n = 191, pharmacologic n = 155) and rest Tc-99m sestamibi SPECT studies. UMI was diagnosed if ECG showed Q wave MI in the absence of history of MI. SPECT infarct size was quantitated based on a 60% of peak counts threshold method and was expressed as a percentage of the left ventricle (% LV). The association between infarct size and mortality was adjusted for clinical and exercise test prognostic scoring systems. Results : The population consisted of 346 UMI, 628 RMI, and 4456 patients without MI (No MI). Compared to No MI, mortality risk was increased in UMI (RR 1.7, 95% CI 1.6–1.9; p < 0.001) and RMI (RR 1.6, 95% CI 1.4–1.9; p < 0.001) patients. In the UMI group, infarct size was significantly associated with mortality ( p < 0.001), which persisted after adjustment for Mayo prognostic score alone (available in all patients) ( p < 0.001) and for Mayo prognostic score, Framingham risk score, and Duke treadmill score (data available in 137 patients) ( p < 0.001). For every 10% LV increase in infarct size, mortality risk increased 30% (RR = 1.3, 95% CI 1.2–1.5) (see figure ). Conclusions: In patients with UMI, larger quantitated SPECT infarct size predicts increased mortality independent of clinical and exercise test prognostic scoring systems. This finding supports the use of infarct size imaging for risk stratification of UMI patients.


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