Prognostic value of preoperative inflammatory markers in resectable biliary tract cancer - Validation and comparison of the Glasgow Prognostic Score and Modified Glasgow Prognostic Score in a Western cohort.

Established preoperative prognostic factors for risk stratification of patients with biliary tract cancer (BTC) are lacking. A prognostic value of the inflammation-based Glasgow Prognostic Score (GPS) and Modified Glasgow Prognostic Score (mGPS) in BTC has been indicated in several Eastern cohorts. We sought to validate and compare the prognostic value of the GPS and the mGPS for overall survival (OS), in a large Western cohort of patients with BTC. We performed a retrospective single-center study for the period 2009 until 2017. 216 consecutive patients that underwent surgical exploration with a diagnosis of perihilar cholangiocarcinoma (PHCC), intrahepatic cholangiocarcinoma (IHCC), or gallbladder cancer (GBC) were assessed. GPS and mGPS were calculated where both CRP and albumin were measured pre-operatively (n = 168/216). Survival was analyzed by Kaplan-Meier estimate and uni-/multivariate Cox regression. GPS and mGPS were negatively associated with survival (p < 0.001/p < 0.001), and the association was significant in all three subgroups. GPS, but not the mGPS, identified an intermediate risk group: with GPS = 1 having better OS than GPS = 2 (p = 0.003), but worse OS than GPS = 0 (p = 0.008). In multivariate analyses of resected patients, GPS (p = 0.001) and mGPS (p = 0.03) remained significant predictors of survival, independent of postoperatively available risk factors. Preoperative GPS and mGPS are independent prognostic factors in BTC. The association to OS was shown in all patients undergoing exploration, in resected patients only, and in both cholangiocarcinoma and gallbladder cancer. Furthermore, GPS - which weights hypoalbuminemia higher - could identify an intermediate risk group.

Jansson H ，Cornillet M ，Björkström NK ，Sturesson C ，Sparrelid E ... -  《-》

Comparison of Inflammation-based Prognostic Scores in Patients With Biliary Tract Cancer After Surgical Resection.

Inflammation-based prognostic scores are proven prognostic biomarkers in various cancers. This study aimed to identify a useful prognostic score for patients with biliary tract cancer (BTC) after surgical resection. This retrospective study recruited 115 patients with BTC during 2010-2020. The relationship between clinicopathological variables, including various prognostic scores and overall survival (OS), was investigated using univariate and multivariate analyses. BTC included 58 cholangiocarcinoma, 29 gallbladder carcinoma, 16 ampullary carcinoma, and 12 perihilar cholangiocarcinoma cases. A significant difference was detected in OS of patients with a Japanese modified Glasgow prognostic score (JmGPS) 0 (n=62) and JmGPS 1 or 2 (high JmGPS) (n=53). In the multivariate analysis, tumour differentiation (p=0.014) and a high JmGPS (p=0.047) were independent prognostic factors. The high JmGPS was an independent prognostic predictor after surgical resection and was superior to other prognostic scores.

Utsumi M ，Kitada K ，Tokunaga N ，Yoshida Y ，Narusaka T ，Hamano R ，Miyasou H ，Tsunemitsu Y ，Otsuka S ，Inagaki M ... -  《-》

Appraisal of inflammation-based prognostic scores in patients with unresectable perihilar cholangiocarcinoma.

Inflammation-based prognostic scores are useful prognostic indicators for several types of cancer. The aim of this study was to evaluate whether the scores predict survival impact in unresectable perihilar cholangiocarcinoma. The modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio, and Prognostic Nutritional Index, were retrospectively assessed in 219 patients with unresectable perihilar cholangiocarcinoma. Of the four scores evaluated, mGPS and NLR demonstrated prognostic value, whereas the remaining two systems did not. The median survival time (MST) of patients with a mGPS of 0 and NLR of 0 or 1 were significantly better than that of patients with a mGPS of 1 or 2 and NLR of 2 (12.3 vs. 4.8 months, P < 0.001, and 10.5 vs. 4.4 months, P = 0.001). Multivariate analysis revealed that both mGPS and NLR were independent prognostic factors. The combination of mGPS and NLR stratified survival well: the MST was 12.8 months in patients with a mGPS of 0 and NLR of 1 or 2, while only 3.0 months in patients with a mGPS of 1 or 2 and NLR of 2. Both mGPS and NLR are independent prognostic factors and pivotal in refining patient stratification in unresectable perihilar cholangiocarcinoma.

Okuno M ，Ebata T ，Yokoyama Y ，Igami T ，Sugawara G ，Mizuno T ，Yamaguchi J ，Nagino M ... -  《-》

Usefulness of an inflammation-based prognostic score (mGPS) for predicting survival in patients with unresectable malignant biliary obstruction.

Iwasaki Y ，Ishizuka M ，Kato M ，Kita J ，Shimoda M ，Kubota K ... -  《-》

Evaluation of inflammation-based prognostic scores in patients undergoing hepatobiliary resection for perihilar cholangiocarcinoma.

Okuno M ，Ebata T ，Yokoyama Y ，Igami T ，Sugawara G ，Mizuno T ，Yamaguchi J ，Nagino M ... -  《-》