Hypoalbuminemia in colorectal cancer prognosis: Nutritional marker or inflammatory surrogate?

Table 3 Glasgow prognostic score and colorectal cancer

Ref.	Design	Objective	Sample size	Findings	Comments
Petrelli et al[50]	Systematic review and meta-analysis	Quantification of impact of mGPS on OS in CRC	2227 patients from 9 studies	High mGPS was associated with worse OS (HR = 1.69) and CSS (HR = 1.84)	Studies in meta-analysis did not control for concurrent conditions that may affect mGPS, such as sepsis or medications
McMillan et al[51]	Systematic review	Relationship between mGPS and cancer outcome	60 studies with 18 on CRC	Higher mGPS in CRC predicted numerous worse outcomes (e.g., postoperative infections, toxicity, survival, etc.)	Study looked at all cancer patients. CRC studies were geographically restricted to the United Kingdom and Japan
Richards et al[52]	Prospective cohort study	Correlation between parameters of body composition and systemic inflammatory response in operable CRC	174 patients	Elevated mGPS was associated with low skeletal muscle index (P = 0.001)	No association seen between skeletal mass index and tumor-related variables such as tumor stage
Read et al[55]	Prospective cohort study	Relationship between inflammatory/nutritional prognostic factors and outcomes in advanced CRC	51 patients	High GPS was associated with worse OS (HR = 2.27), while the nutritional status as measured by validated scores was not on multivariate analysis	Small and heterogeneous study population

GPS: Glasgow prognostic score; mGPS: Modified glasgow prognostic score; CRC: Colorectal cancer; OS: Overall survival; CSS: Cancer-specific survival.