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Clinical Research

Systemic inflammation and survival of patients with prostate cancer: evidence from the Glasgow Inflammation Outcome Study

Prostate Cancer and Prostatic Diseases volume 15, pages 195–201 (2012)Cite this article

Abstract

Background:

There is some evidence that systemic inflammation may be associated with survival in patients with prostate cancer; however, it is unclear whether this is independent of grade. We therefore investigated the role of inflammation-based prognostic scores, the modified Glasgow Prognostic Score (mGPS) and neutrophil lymphocyte ratio (NLR), and their associations with Gleason grade in patients with prostate cancer.

Methods:

Patients from a cohort, the Glasgow Inflammation Outcome Study, who had diagnosis of prostate cancer, were included in this study. The mGPS was constructed by combining C-reactive protein and albumin whereas NLR by calculating the ratio of neutrophils to lymphocytes. We estimated 5-year relative survival and relative excess risk (RER) of death by mGPS and NLR categories after adjusting for age, socioeconomic circumstances and Gleason grade.

Results:

In all, 897 prostate cancer patients were identified; of those 422 (47%) died during a maximum follow-up of 6.2 years. Systemic inflammation appeared to have significant prognostic value. The mGPS predicted poorer 5-year overall and relative survival independent of age, socioeconomic circumstances, disease grade and NLR. Raised mGPS also had a significant association with excess risk of death (mGPS 2: RER =2.41, 95% confidence interval 1.37–4.23) among aggressive, clinically significant prostate cancer (Gleason grades 8–10).

Conclusions:

The mGPS is a strong measure of systemic inflammation, when compared with NLR. Prostate cancer patients with a raised mGPS had significantly higher risk of death for overall as well high-grade disease. Inflammation-based prognostic scores predict outcome in patients with prostate cancer and should be added to their routine clinical assessment.

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Acknowledgements

All authors are paid by their employers.

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Authors and Affiliations

  1. Academic Unit of Public Health, Centre for Population & Health Sciences, University of Glasgow, Glasgow, UK

    K Shafique

  2. University Department of Surgery, Faculty of Medicine, University of Glasgow, Royal Infirmary, Glasgow, UK

    M J Proctor & D C McMillan

  3. Urology Department, Gartnavel General Hospital, Glasgow, UK

    K Qureshi & H Leung

  4. Beatson Institute for Cancer Research, Glasgow, UK

    H Leung

  5. West of Scotland Cancer Surveillance Unit, University of Glasgow, Glasgow, UK

    D S Morrison

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  1. K Shafique
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Correspondence to K Shafique.

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Shafique, K., Proctor, M., McMillan, D. et al. Systemic inflammation and survival of patients with prostate cancer: evidence from the Glasgow Inflammation Outcome Study. Prostate Cancer Prostatic Dis 15, 195–201 (2012). https://doi.org/10.1038/pcan.2011.60

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