In England, many end of life care or hospice-at-home services will provide care for patients with life expectancy of <8–12 weeks. Low serum albumin has been associated with poor survival in carcinoma of stomach. Raised serum C-reactive protein (CRP) levels have also been linked to poor survival in cancer patients. Glasgow Prognostic Score (GPS) combines serum albumin and CRP levels to give a composite score. Poor survival is associated with high GPS in colorectal cancer patients.Aims and objectives
To compare 3 month survival of patients with metastatic cancer using GPSMethods
All adults known to have metastatic cancer pre-admission to district general hospital and hospice over a 2 month period were included. Using serum albumin (>35gm/L=0;<=35 gm/L=1) and serum CRP (<5mg/L=0;>5 mg/L=1), GPS score was assigned (minimum 0; maximum 2). Survival duration, to a maximum follow-up of 3 months, was measured. Survival proportions were compared for GPS scores of 0, 1 and 2.Results
Total number of patients - 106. Women comprised 52%. Mean age was 73.6 years. Common cancers: lung (n=26), urology (n=14), breast (n=12) and colorectal, upper gastrointestinal and hepatobiliary-pancreas (9 each). GPS could be calculated for 79: 0 in one patient, 1 in 33 and 2 in 45. Whereas 36% patients with GPS of 1 died during the admission, 47% of those with GPS of 2 died. At 3 months respective figures were 42% and 62%. Mean survival was 17.69 days with GPS 2; and 28.20 days with GPS 1. The sole patient with GPS 0 died during the inpatient stay.Conclusions
Higher GPS is associated with shorter survival in unselected metastatic cancer patients. This study is too small to determine sensitivity and specificity. A larger study for this inexpensive, widely available and easy to use tool is required.