Significance of the Modified Glasgow Prognostic Score in Predicting the Short-Term Outcome of Patient with Operable Gastric Carcinoma

Abstract

Background: Modified Glasgow Prognostic score (mGPS) is a treatment independent, routinely available, and well standardized prognostic factor, that reflects both an ongoing systemic inflammatory response and a progressive nutritional decline in patients with advanced cancer. Considering the data scarcity in our country context, this study aimed to assess the significance of mGPS for predicting short-term outcome of operable gastric carcinoma patients in a tertiary care hospital of Bangladesh.

Methodology: This observational study was conducted in the Department of General Surgery, Bangabandhu Sheikh Mujib Medical University for 12- month period following acceptance of the protocol from January 2023 to December 2023. A total of 38 patients with gastric carcinoma who underwent curative surgery were included after getting informed written consent. Socio- demographic history, clinical presentation, pre-and post-operative mGPS, and in-hospital outcome were recorded. Data were collected in separate case- record form and analyzed by SPSS-26. In this study Chi-square, paired-t test, multiple response considered & one way ANOVA were used.

Result: The mean age was 58.39 (±10.62 SD) years with male majority (60.5%). Abdominal pain (68.4%), weakness (68.4%), and weight loss (65.8%) were the commonest presentation. Among all patients, two patients (5.3%) died and 11patients (28.9%) developed post-operative complications, mainly Surgical site infection (10.5%), cardiac complication (2.6%), hemorrhage (2.6%), anastomotic leakage (5.3%). The percentage of patients with mGPS 0 decreases from 55.3% pre- operatively to 28.9% post-operatively, while the percentage of patients with mGPS 1 increases from 36.8% to 65.8%. Post- operative complication, especially anastomotic leakage, wound complication, and cardiac complication were associated with higher post-operative mGPS (p<0.05).

Conclusion: The percentage of patients with mGPS 0 significantly decreases post-operatively, while the percentage of patients with mGPS 1 increases post-operatively. Besides, post-operative complications, especially anastomotic leakage, stomal obstruction, wound complication, and cardiac complication were associated with higher post-operative mGPS. Hence, it can be concluded that modified Glasgow Prognostic score is significant association with short-term outcome of patient with operable gastric carcinoma.