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Prediction of Postoperative Clinical Outcomes in Resected Stage I Non-Small Cell Lung Cancer Focusing on the Preoperative Glasgow Prognostic Score

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Division of Thoracic and Hyperbaric Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
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Division of Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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Division of Cancer Medicine, Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, UTHealth, Texas A&M College of Medicine, Houston, TX 77030, USA
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Center for Biomarker Research in Medicine (CBmed), Medical University of Graz, 8036 Graz, Austria
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Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria
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Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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Division of Vascular Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
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Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cancers 2020, 12(1), 152; https://doi.org/10.3390/cancers12010152
Received: 16 December 2019 / Revised: 4 January 2020 / Accepted: 6 January 2020 / Published: 8 January 2020
(This article belongs to the Special Issue C-Reactive Protein in Cancer)
Background: The Glasgow Prognostic Score (GPS), which consists of albumin and C-reactive protein (CRP), may predict overall survival (OS) in cancer patients. The aim of this retrospective analysis was to evaluate the clinical impact of the preoperative GPS on patients with resected early stage non-small cell lung cancer (NSCLC). Methods: 300 patients with curatively resected stage I NSCLC were followed-up for OS, recurrence-free survival (RFS), cancer-specific survival (CSS), and death from other causes. Results: 229 patients (76%) had a preoperative GPS of 0, and 71 (24%) a GPS ≥ 1. The three-year probabilities of RFS, OS, CSS, and death from other causes were 81%, 84%, 88%, and 96% in patients with GPS = 0, and 79%, 74%, 91%, and 82% in patients with a GPS ≥ 1, respectively. GPS ≥ 1 was significantly associated with a higher risk of death from other causes (p = 0.022), serving as an independent predictor of death from other causes (p = 0.034). Pathologically elevated CRP levels (CRP > 5 mg/L) were found in 91 patients (30%). The mean CRP level was 7.88 ± 15.80 mg/L (0.5–135.6 mg/L). Pre-treatment CRP level was significantly associated with coronary heart disease (p < 0.0001), histology (p = 0.013), tumor size (p = 0.018), tumor stage (p = 0.002), and vascular invasion (p = 0.017). Conclusion: The preoperative GPS predicts adverse survival outcomes in patients with resected stage I NSCLC. View Full-Text
Keywords: Non-small cell lung cancer; early tumor stage; operation; C-reactive protein; Glasgow Prognostic Score; prognosis Non-small cell lung cancer; early tumor stage; operation; C-reactive protein; Glasgow Prognostic Score; prognosis
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Lindenmann, J.; Fink-Neuboeck, N.; Taucher, V.; Pichler, M.; Posch, F.; Brcic, L.; Smolle, E.; Koter, S.; Smolle, J.; Smolle-Juettner, F.M. Prediction of Postoperative Clinical Outcomes in Resected Stage I Non-Small Cell Lung Cancer Focusing on the Preoperative Glasgow Prognostic Score. Cancers 2020, 12, 152.

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