Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec 7;13(24):6154.
doi: 10.3390/cancers13246154.

Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts

Nadia Oubaya  1   2 , Pierre Soubeyran  3 , Nicoleta Reinald  1 , Marianne Fonck  3 , Mylène Allain  1   4 , Sonia Zebachi  1 , Damien Heitz  5 , Marie Laurent  1   6 , Cécile Delattre  7 , Philippe Caillet  1   8 , Jérôme Dauba  9 , Sylvie Bastuji-Garin  1   2 , Gilles Albrand  10 , Michael Bringuier  11 , Muriel Rainfray  12 , Etienne Brain  11 , Thomas Grellety  3 , Elena Paillaud  1   8 , Simone Mathoulin-Pélissier  13   14 , Carine Bellera  13   14 , Florence Canouï-Poitrine  1   2
Affiliations

Prognostic Value of Routinely Measured Inflammatory Biomarkers in Older Cancer Patients: Pooled Analysis of Three Cohorts

Nadia Oubaya et al. Cancers (Basel). .

Abstract

Background: The prognostic assessment of older cancer patients is complicated by their heterogeneity. We aimed to assess the prognostic value of routine inflammatory biomarkers.

Methods: A pooled analysis of prospective multicenter cohorts of cancer patients aged ≥70 was performed. We measured CRP and albumin, and calculated Glasgow Prognostic Score (GPS) and CRP/albumin ratio. The GPS has three levels (0 = CRP ≤ 10 mg/L, albumin ≥ 35 g/L, i.e., normal values; 1 = one abnormal value; 2 = two abnormal values). One-year mortality was assessed using Cox models. Discriminative power was assessed using Harrell's C index (C) and net reclassification improvement (NRI).

Results: Overall, 1800 patients were analyzed (mean age: 79 ± 6; males: 62%; metastases: 38%). The GPS and CRP/albumin ratio were independently associated with mortality in patients not at risk of frailty (hazard ratio [95% confidence interval] = 4.48 [2.03-9.89] for GPS1, 11.64 [4.54-29.81] for GPS2, and 7.15 [3.22-15.90] for CRP/albumin ratio > 0.215) and in patients at risk of frailty (2.45 [1.79-3.34] for GPS1, 3.97 [2.93-5.37] for GPS2, and 2.81 [2.17-3.65] for CRP/albumin ratio > 0.215). The discriminative power of the baseline clinical model (C = 0.82 [0.80-0.83]) was increased by adding GPS (C = 0.84 [0.82-0.85]; NRI events (NRI+) = 10% [2-16]) and CRP/albumin ratio (C = 0.83 [0.82-0.85]; NRI+ = 14% [2-17]).

Conclusions: Routine inflammatory biomarkers add prognostic value to clinical factors in older cancer patients.

Keywords: biomarkers; cancer; mortality; older patients.

PubMed Disclaimer

Conflict of interest statement

The authors have declared no conflict of interest.

Figures

Figure 1
Figure 1
Study flowchart.
Figure 2
Figure 2
Multivariable analysis of GPS, mGPS, CRP, albumin and CRP/albumin ratio with regard to one-year mortality (n = 1604).
Figure 3
Figure 3
Overall survival according to GPS (A) and CRP/albumin ratio (B), stratified by G8 score (n = 1800). GPS: Glasgow Prognostic Score; CAR: C-reactive protein/albumin ratio.
Figure 3
Figure 3
Overall survival according to GPS (A) and CRP/albumin ratio (B), stratified by G8 score (n = 1800). GPS: Glasgow Prognostic Score; CAR: C-reactive protein/albumin ratio.
See this image and copyright information in PMC

References

    1. Amano K., Morita T., Tatara R., Katayama H., Uno T., Takagi I. Association between early palliative care referrals, inpatient hospice utilization, and aggressiveness of care at the end of life. J. Palliat. Med. 2015;18:270–273. doi: 10.1089/jpm.2014.0132. - DOI - PubMed
    1. Seaman R., Hohn A., Lindahl-Jacobsen R., Martikainen P., van Raalte A., Christensen K. Rethinking morbidity compression. Eur. J. Epidemiol. 2020;35:381–388. doi: 10.1007/s10654-020-00642-3. - DOI - PMC - PubMed
    1. Canoui-Poitrine F., Lievre A., Dayde F., Lopez-Trabada-Ataz D., Baumgaertner I., Dubreuil O., Brunetti F., Coriat R., Maley K., Pernot S., et al. Inclusion of Older Patients with Cancer in Clinical Trials: The SAGE Prospective Multicenter Cohort Survey. Oncologist. 2019;24:e1351–e1359. doi: 10.1634/theoncologist.2019-0166. - DOI - PMC - PubMed
    1. Kenis C., Baitar A., Decoster L., De Greve J., Lobelle J.P., Flamaing J., Milisen K., Wildiers H. The added value of geriatric screening and assessment for predicting overall survival in older patients with cancer. Cancer. 2018;124:3753–3763. doi: 10.1002/cncr.31581. - DOI - PubMed
    1. Kenis C., Decoster L., Van Puyvelde K., De Greve J., Conings G., Milisen K., Flamaing J., Lobelle J.P., Wildiers H. Performance of two geriatric screening tools in older patients with cancer. J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol. 2014;32:19–26. doi: 10.1200/JCO.2013.51.1345. - DOI - PubMed