Therefore, the value of a systemic inflammation-based score (Glasgow Prognostic Score, GPS) was evaluated in patients with metastatic breast cancer (n=96). The GPS was constructed as follows; patients with both an elevated C-reactive protein (>10 mg/1) and hypoalbuminaemia (<35g/l) were allocated a score of 2. Patients in whom only one or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. The minimum follow-up was 7 months and the median follow-up of the survivors was 16 months. During this period 51 patients died of their cancer. On multivariate analysis, only the GPS (HR 2.26, 95% CI 1.45-3.52, P<0.001) remained significantly associated with cancer-specific survival. The median survival in these patients was 24 months, 13 months and 1 month for a GPS of 0, 1 and 2, respectively. Therefore, the presence of a systemic inflammatory response, the GPS that based on simple routinely available and well-standardised measurements, appeal's to be a useful independent indicator of poor outcome in patients with metastatic breast cancer. In patients with early-staged invasive disease, the prognostic value of the relationship between the systemic inflammatory response; as evidenced by elevated C-reactive protein and lowered albumin concentrations that were measured prior to surgery, standard clinico-pathologic factors and cancer outcome was examined in 300 patients with operable primary cancer. The results of the studies suggest that the systemic inflammatory response, as measured by GPS, may be a useful tool in the assessment of survival in patients with systemic metastatic breast cancer. Moreover, the host inflammatory responses are closely related to poor tumour differentiation and hormone-negativity, and malignant disease progression in patients with early-staged invasive breast cancer. Furthermore, that the tumour-based cell mediated immune response and pathological factors are subordinate to the systemic factors, such as albumin, in determining survival in patients with primary loco-regional operable disease. Future prognostic studies should be large enough and over adequate follow-up time and should include all potential prognostic factors in the multivariate survival analysis. (Abstract shortened by ProQuest.)
