Abstract
Context
In advanced cancer, although performance status (PS), systemic inflammatory response
and nutritional status are known to have prognostic value, geographical variations
and sociodemographic indexes may also impact survival.
Objectives
This study compares validated prognostic factors in two international cohorts and
establishes a prognostic framework for treatment.
Methods
Two international biobanks of patients (n=1.518) with advanced cancer were analyzed.
Prognostic factors (Eastern Cooperative Oncology Group Performance Status [ECOG-PS],
body mass index [BMI] and modified Glasgow Prognostic Score [mGPS]) were assessed.
The relationship between these and survival was examined using Kaplan–Meier and Cox
regression methods.
Results
According to multivariate analysis, in the European cohort the most highly predictive
factors were BMI <20 kg/m2 (hazard ratio [HR] 1.644), BMI 20-21.9 kg/m2 (HR 1.347), ECOG-PS (HR 1.597–11.992) and mGPS (HR 1.843–2.365). In the Brazilian
cohort, the most highly predictive factors were ECOG-PS (HR 1.678–8.938) and mGPS
(HR 2.103–2.837). Considering gastrointestinal cancers in particular (n=551), the
survival rate at 3 months in both cohorts together ranged from 93% (mGPS 0, PS 0–1)
to 0% (mGPS 2, PS 4), and from 81% (mGPS 0, BMI >28 kg/m2) to 44% (mGPS 2, BMI <20 kg/m2).
Conclusion
The established prognostic factors that were compared had similar prognostic capacity
in both cohorts. A high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework
were consistently associated with poorer survival of patients with advanced cancer
in the prospective European and Brazilian cohorts.
Key Words
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Article info
Publication history
Published online: December 06, 2022
Accepted:
November 29,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
