Glasgow Prognostic Score (GPS) for Cancer Outcomes

Why Use

Multiple studies suggest significantly worse outcome in multiple types of cancer, including “increased weight loss, poor performance status, increased comorbidity, increased pro-inflammatory and angiogenic cytokines and complications on treatment.” ( McMillan DC 2013 )

When to Use

Patients with known cancer.

Formula

Pearls / Pitfalls

The Glasgow Prognostic Score (GPS) has been evaluated across numerous different cancer cohorts and suggests incrementally worsening prognosis with increasing score. Depending upon patient selection, stage, cancer and other factors the resulting survival numbers vary widely. The modified GPS uses the same parameters as the original GPS (CRP and albumin), but weighs the inflammatory component more heavily; i.e., patients with low albumin are still assigned a score of 0 even if CRP is elevated. The modified GPS was shown to have better correlation with survival (in colon and rectal cancer from the original paper, and in other cancers from the validation papers).

Management

We are unaware of validated management algorithms using the GPS.

Critical Actions

The GPS requires serum laboratory values and may be relevant when drawn prior to or after cancer diagnosis.

Advice

The Glasgow Prognosis Score (GPS) helps stratify prognosis groups and may be a worthy addition to multifactorial evaluations.

More Information

The GPS has been shown to be accurate in different types of cancer, including cervical, renal, lung, gastric cancers, as well as in primary care. However, the score has been modified with better predictive values.