Association between pretreatment Glasgow prognostic score and gastric cancer survival and clinicopathological features: a meta-analysis

BACKGROUND Glasgow prognostic score (GPS) is widely known as a systemic inflammatory-based marker. The relationship between pretreatment GPS and gastric cancer (GC) survival and clinicopathological features remains controversial. The aim of the study was to conduct a meta-analysis of published studies to evaluate the association between pretreatment GPS and survival and clinicopathological features in GC patients. METHODS We searched PubMed, Embase, MEDLINE, and BioMed databases for relevant studies. Combined analyses were used to assess the association between pretreatment GPS and overall survival, disease-free survival, and clinicopathological parameters by Stata Version 12.0. RESULTS A total of 14 studies were included in this meta-analysis, including 5,579 GC patients. The results indicated that pretreatment high GPS (HGPS) predicted poor overall survival (hazard ratio =1.51, 95% CI: 1.37-1.66, P<0.01) and disease-free survival (hazard ratio =1.45, 95% CI: 1.26-1.68, P<0.01) in GC patients. Pretreatment HGPS was also significantly associated with advanced tumor-node-metastasis stage (odds ratio [OR] =3.09, 95% CI: 2.11-4.53, P<0.01), lymph node metastasis (OR =4.60, 95% CI: 3.23-6.56, P<0.01), lymphatic invasion (OR =3.04, 95% CI: 2.00-4.62, P<0.01), and venous invasion (OR =3.56, 95% CI: 1.81-6.99, P<0.01). CONCLUSION Our meta-analysis indicated that pretreatment HGPS could be a predicative factor of poor survival outcome and clinicopathological features for GC patients.