The prognostic value of modified Glasgow Prognostic Score in pancreatic cancer: a meta-analysis
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Cancer Cell International Open Access
PRIMARY RESEARCH
The prognostic value of modified Glasgow Prognostic Score in pancreatic cancer: a metaanalysis Huan Zhang1,2†, Dianyun Ren1,2†, Xin Jin1,2,3* and Heshui Wu1,2*
Abstract Background: Several studies were conducted to explore the prognostic value of modified Glasgow Prognostic Score (mGPS) in pancreatic cancer, which reported contradictory results. The purpose of this meta-analysis was to summarize and further investigate the correlation between mGPS and overall survival (OS) in pancreatic cancer. Methods: A systematic literature search was performed in PubMed, EMBASE, ISI Web of Science, Cochrane library databases and OVID to identify eligible studies published from Jan 1, 2011 to June 20, 2020. Pooled hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) were used to detect the prognostic significance of mGPS in patients with pancreatic cancer. Results: A total of 222 non-repetitive studies were identified, and 20 related studies that explored the association between survival outcomes and mGPS in pancreatic cancer patients were finally enrolled in this meta-analysis. The results showed a significant correlation between high level of mGPS and poor OS (HR = 1.50, 95% CI 1.20–1.89, P 10 mg/L) and hypoalbuminemia ( 50% indicated significant heterogeneity. The fixed effect model was used only when I 2 0.05 implying no significant publication bias. All statistical analyses were performed by STATA version 15.0 (StataCorp, College Station, TX, USA).
Zhang et al. Cancer Cell Int
(2020) 20:462
Results Study selection and characteristics
A total of 222 papers were initially retrieved from PubMed, Web of Science, EMBASE and Cochrane library database. As shown in Fig. 1, the literature search process was summarized in the flow diagram according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) [23]. Ultimately, 20 studies [8, 15–18, 24–38] including 6512 patients were enrolled in this meta-analysis after excluding ineligible studies. Basic characteristics and main outcomes of the included 20 studies were shown in Table 1. These studies were published from 2011 to 2020, with a research duration ranging from 2000 to 2017. The sample size of these studies ranged from 47 to 1347, with a total number was 6512. As for the therapeutic methods, patients in 14 studies received chemotherapy, and pancreatectomy was chosen in another 6 studies. The NOS score
Fig. 1 Flow diagram of selecting relevant published works
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of all included studies were equal or greater than 5, which meant relatively high quality. 16 studies were conducted in Asia (including China, Japan, and South Korea), and 4 studies were performed in western countries (including the United Kingdom, Italy and Australia). Most studies were assessed with multivariate analysis except that 4 studies were only assessed with univariate analysis. Prognostic value of mGPS in pancreatic cancer
As shown in Table 2; Fig. 2, a total of 20 studies evaluated the
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