Comparison of inflammation-based prognostic scores as predictors of survival outcomes in patients with germ cell tumors

Investig Clin Urol. 2021 Jan;62(1):47-55. doi: 10.4111/icu.20200103. Epub 2020 Dec 9.

Abstract

Purpose: The aim of this study was to compare the prognostic value of pretreatment inflammation-based scoring systems in terms of overall survival (OS) and progression-free survival (PFS) in patients with germ cell tumors (GCTs) receiving bleomycin, etoposide, and cisplatin (BEP) chemotherapy.

Materials and methods: We evaluated 63 patients with GCTs retrospectively. The Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio, prognostic index, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index, and albumin-to-globulin ratio (AGR) were measured in all patients before chemotherapy. To assess the predictive ability of each scoring system, areas under the receiver operating characteristic curve were calculated, and multivariate analysis was performed to identify associations between the predictive scores and OS.

Results: Of all the inflammation-based scoring systems, the GPS had the greatest area under the curve (0.847) for predicting OS, followed by the PNI (0.829) and AGR (0.810). Kaplan-Meier analyses revealed that the GPS, PNI, and AGR were significantly associated with OS, whereas the GPS, PLR, and PNI were significantly associated with PFS. In the multivariate analysis, the GPS was an independent predictor of OS and PFS.

Conclusions: We demonstrated that the GPS was the most valuable biomarker of OS and PFS in patients with GCTs.

Keywords: Germ cell tumor; Glasgow prognostic score; Prognostic nutritional index.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Area Under Curve
  • Bleomycin / therapeutic use
  • C-Reactive Protein / metabolism
  • Cisplatin / therapeutic use
  • Etoposide / therapeutic use
  • Humans
  • Inflammation / blood*
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neutrophils
  • Platelet Count
  • Prognosis
  • Progression-Free Survival
  • ROC Curve
  • Retrospective Studies
  • Seminoma / blood*
  • Seminoma / drug therapy*
  • Serum Albumin / metabolism
  • Serum Globulins / metabolism
  • Survival Rate
  • Testicular Neoplasms / blood*
  • Testicular Neoplasms / drug therapy*
  • Young Adult

Substances

  • Serum Albumin
  • Serum Globulins
  • Bleomycin
  • Etoposide
  • C-Reactive Protein
  • Cisplatin

Supplementary concepts

  • BEP protocol