To evaluate the prognostic role of modified Glasgow prognostic score (mGPS) for the prediction of oncological outcomes in a retrospective large multicenter cohort of upper tract urothelial carcinoma (UTUC) patients treated with radical nephroureterectomy (RNU).
We retrospectively analyzed a multicenter cohort of patients treated with RNU for clinically nonmetastatic UTUC. Multivariable logistic regression analyses were performed to evaluate the ability of mGPS to predict nonorgan confined (NOC) disease and lymph-node involvement (LNI) at RNU. Multivariable Cox-regression models were performed to evaluate the preoperative and postoperative prognostic effect of mGPS on survival outcomes.
Overall, 2,492 patients were included in the study. Of these, 1,929 (77%), 530 (21%), and 33 (1%) had a mGPS of 0, 1, and 2, respectively. mGPS was associated with characteristics of tumor aggressiveness and independently predicted LNI and NOC at RNU (both P < 0.05). On univariable and multivariable Cox-regression analyses, higher mGPS was independently associated with recurrence-free, cancer-specific, and overall survival, both in a preoperative and in a postoperative setting. The inclusion of mGPS significantly improved the discrimination of a preoperative model for the prediction of oncologic outcomes compared to standard prognosticators.
We found that mGPS is independently associated with clinicopathologic features and survival outcomes after RNU. Future studies should investigate the role of mGPS in a panel of preoperative markers for the prediction of NOC and LNI in UTUC patients, thus possibly improving the selection for perioperative systemic therapy.
Urologic oncology. 2020 Feb 06 [Epub ahead of print]
Francesco Soria, Andrea Giordano, David D'Andrea, Marco Moschini, Morgan Rouprêt, Vitaly Margulis, Pierre I Karakiewicz, Alberto Briganti, Karim Bensalah, Romain Mathieu, Piotr Chlosta, Marek Babjuk, Petr V Glybochko, Dmitry V Enikeev, Mesut Remzi, Kilian Gust, Paolo Gontero, Shahrokh F Shariat
Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy; Department of Urology, Medical University of Vienna, Vienna, Austria., Division of Urology, Department of Surgical Sciences, Torino School of Medicine, Torino, Italy., Department of Urology, Medical University of Vienna, Vienna, Austria., Department of Urology, Medical University of Vienna, Vienna, Austria; Klinik für Urologie, Luzerner Kantonsspital, Lucerne, Switzerland., Sorbonne Université, GRC n°5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France., Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA., Department of Urology, University of Montreal, Montreal, Canada., Department of Urology, Urological Research Institute, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy., Department of Urology, University of Rennes, Rennes, France., Department of Urology, Jagiellonian University, Krakow, Poland., Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic., Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia., Department of Urology, Medical University of Vienna, Vienna, Austria; Department of Urology, University of Texas Southwestern Medical Center, Dallas, USA; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Institute for Urology and Reproductive Health, I.M. Sechenov First Moscow State Medical University, Moscow, Russia; Department of Urology, Weill Cornell Medical College, New York, USA. Electronic address: .