Felicia T Roncolato1, Dominique Berton-Rigaud2, Rachel O'Connell3, Anne Lanceley4, Jalid Sehouli5, Luke Buizen3, Aikou Okamoto6, Eriko Aotani7, Domenica Lorusso8, Paul Donnellan9, Amit Oza10, Elisabeth Avall-Lundqvist11, Jonathan Berek12, Felix Hilpert13, Jonathan A Ledermann14, Marie Christine Kaminsky15, Martin R Stockler3, Madeleine T King16, Michael Friedlander17. 1. NHMRC Clinical Trials Centre, University of Sydney, Australia; Macarthur Cancer Therapy Centre, NSW, Australia; Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia. Electronic address: felicia.roncolato@ctc.usyd.edu.au. 2. ICO Centre René Gauducheau, Saint Herblain, France. 3. NHMRC Clinical Trials Centre, University of Sydney, Australia. 4. University College London, United Kingdom. 5. Charite Berlin, Germany. 6. Jikei University School of Medicine, Japan. 7. Kitasato Academic Research Organization, Japan. 8. MITO, Rome, Italy. 9. Galway University Hospital, Ireland; All-Ireland Oncology Research Group (ICORG), Ireland. 10. Princess Margaret Hospital, Canada. 11. Department of Oncology, Department of Clinical and Experimental Medicine, Linkoping, Sweden, Karolinska Institutet, Stockholm, Sweden. 12. Stanford Women's Cancer Center, USA. 13. Klinik fur Gynakologie und Geburtshilfe, UKSH, Germany. 14. CRUK and UCL Cancer Trials Centre, NCRI UK, United Kingdom. 15. ICL Institut de Cancérologie de Lorraine, Vandoeuvre-Les-Nancy, France. 16. Psycho-oncology Research Group (PoCoG), School of Psychology, Central Clinical School, Sydney Medical School, University of Sydney, Australia. 17. Australia New Zealand Gynaecological Oncology Group (ANZGOG), Australia; Prince of Wales Hospital, Sydney, Australia.
Abstract
BACKGROUND: Modified Glasgow Prognostic Score (mGPS) is predictive of survival in many advanced cancers, but has not been evaluated in recurrent ovarian cancer (ROC). The aim was to determine validity of mGPS in ROC, investigate its associations with health related quality of life (HRQL) and ECOG performance status (PS). METHODS: mGPS is based on serum C reactive protein (CRP) and albumin, with scores ranging from 0 (least) to 2 (most). HRQL was measured with EORTC QLQ C-30 and OV-28. χ2 tests for trend were used to examine the relationship between HRQL, PS and mGPS. Cox proportional hazards regression was used to assess associations between mGPS, HRQL, clinicopathological factors, and overall survival (OS). RESULTS: Inflammatory markers were available in 516 of 948 patients in GCIG SBS. 200(39%) had potentially platinum sensitive ROC with ≥3 lines of chemotherapy, 316(61%) had platinum resistant ROC. 282(55%), 123(24%), 111(22%) had mGPS of 0, 1, 2, respectively. Median OS (months) was 18.1, 9.6, and 6.6 for mGPS 0, 1, and 2 respectively. mGPS was an independent predictor of OS after adjusting for PS and platinum sensitivity (p<0.001). mGPS remained a predictor of OS after adjusting for physical function, role function, global health status, abdominal/GI symptoms, and multiple clinicopathologic factors (p=0.02). Worse PS and higher mGPS were associated with poorer HRQL (p<0.001). Higher mGPS was associated with worse HRQL, independent of PS. CONCLUSION: The mGPS is an independent predictor of OS in ROC after adjusting for HRQL and clinicopathological factors. Higher mGPS is associated with worse HRQL independent of PS. mGPS is simple, inexpensive and may be suitable for clinical practice, clinical trial patient selection and stratification. Crown
BACKGROUND: Modified Glasgow Prognostic Score (mGPS) is predictive of survival in many advanced cancers, but has not been evaluated in recurrent ovarian cancer (ROC). The aim was to determine validity of mGPS in ROC, investigate its associations with health related quality of life (HRQL) and ECOG performance status (PS). METHODS: mGPS is based on serum C reactive protein (CRP) and albumin, with scores ranging from 0 (least) to 2 (most). HRQL was measured with EORTC QLQ C-30 and OV-28. χ2 tests for trend were used to examine the relationship between HRQL, PS and mGPS. Cox proportional hazards regression was used to assess associations between mGPS, HRQL, clinicopathological factors, and overall survival (OS). RESULTS: Inflammatory markers were available in 516 of 948 patients in GCIGSBS. 200(39%) had potentially platinum sensitive ROC with ≥3 lines of chemotherapy, 316(61%) had platinum resistant ROC. 282(55%), 123(24%), 111(22%) had mGPS of 0, 1, 2, respectively. Median OS (months) was 18.1, 9.6, and 6.6 for mGPS 0, 1, and 2 respectively. mGPS was an independent predictor of OS after adjusting for PS and platinum sensitivity (p<0.001). mGPS remained a predictor of OS after adjusting for physical function, role function, global health status, abdominal/GI symptoms, and multiple clinicopathologic factors (p=0.02). Worse PS and higher mGPS were associated with poorer HRQL (p<0.001). Higher mGPS was associated with worse HRQL, independent of PS. CONCLUSION: The mGPS is an independent predictor of OS in ROC after adjusting for HRQL and clinicopathological factors. Higher mGPS is associated with worse HRQL independent of PS. mGPS is simple, inexpensive and may be suitable for clinical practice, clinical trial patient selection and stratification. Crown