I met with Dr. Kashif Shafique of the University of Glasgow who was the senior author of a research poster presented at the meeting. He and his colleagues look at the relationship between systemic inflammation and prostate cancer survival.
Since there is some evidence that pre-treatment of systemic inflammation in men may be associated with changes survival in men with prostate cancer they decided to examine this information from the Glasgow Inflammation Study to evaluate this evidence.
The researchers said that since it is unclear whether this evidence is independent of the gleason grade and stage of the diagnosed prostate cancer they decided to investigated the role of inflammation-based prognostic scores; the modified Glasgow Prognostic Score (mGPS) and Neutrophil Lymphocyte Ratio (NLR) and their associations with Gleason grade and socioeconomic circumstances in men with prostate cancer.
Their data was extracted from men who were diagnosed with prostate cancer who also were a part of the Glasgow Inflammation Outcome Study. They constructed the mGPS scores by combining C-reactive protein and albumin while NLR scores were calculated by taking the ratio of neutrophils to lymphocytes. They then estimated five-year relative survival using the age, gender and deprivation specific life tables and relative excess risk of death by mGPS and NLR categories after adjusting for age, socioeconomic circumstances and Gleason grade.
They found that of the eight hundred and ninety seven prostate cancer patients who were identified from the study; of those 422 (47%) died during a maximum follow up of 6.2 years. Systemic inflammation appeared to have significant prognostic value.
The mGPS predicted poorer 5-year overall and relative survival independent of age, socioeconomic circumstances, disease grade and NLR. Raised mGPS also had a significant association with excess risk of death (mGPS 2: Relative Excess Risk = 2.41, 95% CI 1.37-4.23) among aggressive, clinically significant prostate cancer (Gleason grades 8-10). Similarly, age-specific analyses were also carried out and raised mGPS showed significantly higher risk of death among those with age 75 years.
They found that the mGPS is a strong measure of systemic inflammation in men with prostate cancer. Men with a raised mGPS had significantly higher risk of death for overall as well high grade disease.They concluded that Inflammation-based prognostic scores do predict survival outcomes in men with prostate cancer and should be added to their routine clinical assessment.
I asked him if he would recommend that all men diagnosed with prostate cancer consider starting drugs that would reduce overall inflammation, especially men with high rates of inflammation. He responded that at the current time he could not make that recommendation. However, he did point out that in Europe there are a number of on-going clinical trials evaluating the use of anti-inflammatory drugs to see if survival can be extended, however none of these trials are looking at prostate cancer survival.
He did recommend that men with prostate cancer monitor their levels of inflammation as of the on-set of treatment.
Systemic inflammation and survival of patients with prostate cancer: Evidence from the Glasgow Inflammation Outcome Study.
Kashif Shafique1, Michael Proctor1, Donald McMillan1, Khaver Qureshi2, Hing Leung1, David Morrison1.1University of Glasgow, Glasgow, United Kingdom; 2Gartnavel General Hospital, Glasgow, United Kingdom
Joel T. Nowak, M.A., M.S.W.