The high-sensitivity modified Glasgow prognostic score is superior to the modified Glasgow prognostic score as a prognostic predictor for head and neck cancer

// Nobuhiro Hanai 1 , Michi Sawabe 1, 2 , Takahiro Kimura 1, 3 , Hidenori Suzuki 1 , Taijiro Ozawa 1, 4 , Hitoshi Hirakawa 1, 5 , Yujiro Fukuda 1, 6 and Yasuhisa Hasegawa 1, 7 1 Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Aichi, Japan 2 Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan 3 Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan 4 Department of Otolaryngology, Toyohashi Municipal Hospital, Aichi, Japan 5 Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan 6 Department of Otolaryngology, Kawasaki Medical School, Okayama, Japan 7 Department of Head and Neck Surgery and Otolaryngology, Asahi University Hospital, Gifu, Japan Correspondence to: Nobuhiro Hanai, email: hanai@aichi-cc.jp Keywords: modified Glasgow prognostic score; high-sensitivity modified Glasgow prognostic score; head and neck cancer; C-reactive protein; survival Received: August 06, 2018      Accepted: November 26, 2018      Published: December 11, 2018 ABSTRACT Background: There is increasing evidence that the inflammatory indices of modified Glasgow prognostic score (mGPS) and high-sensitivity mGPS (HS-mGPS) play important roles in predicting the survival in many cancer; however, evidence supporting such an association in head and neck cancer (HNC) is scarce. Materials and Methods: We evaluated the impact of the mGPS and HS-mGPS on the overall survival (OS) in 129 patients with HNC treated at Aichi Cancer Center Central Hospital from 2012-2013. The mGPS was calculated as follows: mGPS of 0, C-reactive protein (CRP) ≤1.0 mg/dl; 1, CRP >1.0 mg/dl; 2, CRP>1.0 mg/dl and albumin <3.5 mg/dl. Regarding the HS-mGPS, the CRP threshold level was set as 0.3 mg/dl. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated by Cox proportional hazard models after adjusting for potential confounders. Results: The prognosis of HNC worsened significantly as both the mGPS and HS-mGPS increased in a univariate analysis. After adjusting for covariates, the HS-mGPS was significantly associated with the OS (adjusted HR for HS-mGPS of 2 compared to an HS-mGPS of 0 [HR score2-0 ] 3.14 [95% CI: 1.23-8.07], P trend < 0.001), while the mGPS was suggested to be associated with the survival (HR score2-0 2.37 [95% CI:0.89-6.33], P trend = 0.145). Even after stratification by clinical covariates, these associations persisted. Conclusion: We conclude that the HS-mGPS is useful as an independent prognostic factor in HNC.