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.