Prognostic Value of High-Sensitivity Modified Glasgow Prognostic Score in Castration-Resistant Prostate Cancer Patients Who Received Docetaxel

Simple Summary Prostate cancer is one of the most prevalent cancers in men. Prostate cancer is characterized by an early response to hormonal therapy and prostate-specific antigen (PSA) is useful for diagnosis, prognosis, and treatment evaluation. However, if the patient becomes resistant to treat and develops castration-resistant prostate cancer (CRPC), it is difficult to predict prognosis and evaluate response to treatment using PSA alone. In this study, we found that the high-sensitivity modified Glasgow prognostic score (Hs-mGPS), an inflammatory response score, is a more powerful prognostic factor for CRPC than the modified Glasgow prognostic score (mGPS) previously studied. Furthermore, we suggest that risk classification using Hs-mGPS, PSA, and testosterone (TST) may be a useful tool to predict the prognosis of late staged CRPC. The Glasgow prognostic score, a marker of systemic inflammation, is associated with clinical outcomes in different cancers including prostate cancer. However, there is no evidence for the relationship between the high-sensitivity modified Glasgow prognostic score (Hs-mGPS) in prostate cancer and its prognosis. This study aimed to investigate the prognostic significance of Hs-mGPS in castration-resistant prostate cancer (CRPC) treated with docetaxel. We retrospectively analyzed clinical datasets from 131 CRPC patients who received docetaxel treatment at Chiba University Hospital and a related hospital. Clinical factors including Hs-mGPS before docetaxel treatment were evaluated according to overall survival. The numbers of patients with Hs-mGPS of 0, 1, and 2 were 88, 30, and 13, respectively. The median prostate-specific antigen (PSA) level was 28.9 ng/mL. The median testosterone level was 13.0 ng/dL. The percentages of bone and visceral metastases were 80.8% and 10.2%, respectively. For overall survival, Hs-mGPS >= 1 (hazard ratio of 2.41; p = 0.0048), testosterone >= 13.0 ng/dL (hazard ratio of 2.23; p = 0.0117), and PSA >= 28.9 ng/mL (hazard ratio of 2.36; p = 0.0097) were significant poor prognostic factors in the multivariate analysis. The results of the two-group analysis showed that a higher Hs-mGPS was associated with high PSA, alkaline phosphatase, and testosterone levels. The median testosterone levels for Hs-mGPS of 0, 1, and 2 were 9.0, 16.5, and 23.0, respectively. Based on the multivariate analysis, we created a combined score with three prognostic factors: Hs-mGPS, testosterone, and PSA. The low-risk group (score of 0-1) showed a significantly longer overall survival compared to the intermediate-risk (score of 2-3) and high-risk (score of 4) groups (p < 0.0001). Our results demonstrated that an elevated Hs-mGPS was an independent prognostic factor in CRPC patients treated with docetaxel therapy. Risk classification based on Hs-mGPS, testosterone, and PSA may be useful in predicting the prognosis of CRPC patients.

Automated summary

The high-sensitivity modified Glasgow prognostic score (Hs-mGPS) is a powerful prognostic factor for castration-resistant prostate cancer (CRPC), with risk classification using Hs-mGPS, PSA, and testosterone (TST) potentially useful in predicting prognosis for late staged CRPC patients. An elevated Hs-mGPS was shown to be an independent prognostic factor in CRPC patients treated with docetaxel therapy.