Prognostic value of the Glasgow Prognostic Score in renal cell carcinoma: a meta-analysis.

Purpose: Glasgow Prognostic Score (GPS) has been reported to predict oncologic outcomes in various type of cancer. However, their prognostic value in patients with renal cell carcinoma (RCC) is unclear. In this meta-analysis, we evaluated the prognostic significance of GPS in RCC patients.
Methods: We performed comprehensive searches of electronic databases to identify studies that evaluated the prognostic impact of pretreatment GPS in RCC patients. The end points were cancer-specific survival (CSS), recurrence-free/disease-free survival (RFS/DFS). Meta-analysis using random-effects models was performed to calculate hazard ratios (HRs) or odds ratios with 95 % confidence intervals (CIs).
Results: Nine retrospective, observational, cohort studies involving 2096 patients were included. Seven studies evaluated CSS, and three evaluated RFS. Our results showed that higher GPS (0 vs. 1 vs. 2) was significantly predictive of poorer CSS (HR 3.68, 95 % CI 2.52-5.40, p < 0.001) and RFS/DFS (HR 2.83, 95 % CI 1.86-4.30, p < 0.001) in patients with RCC. These findings were robust when stratified by sample size, presence of metastasis, and study region. We also conducted subgroup analysis by assessment of Newcastle-Ottawa quality assessment scale (NOS) score, and the HRs were 2.708 (95 % CI 1.969, 3.725) in under 7 points group, 3.685 (95 % CI 2.516, 5.396) in over than 7 points group in CSS. Meta-regression analysis indicated that NOS score group had a significant difference in HRs (p = 0.032).
Conclusions: Higher GPS is associated with tumor progression and is predictive of poorer survival in patients with RCC. Therefore, GPS may help to inform treatment decisions and predict treatment outcomes.