Prognostic Role Of Modified Glasgow Prognostic Score In Patients With Cholangiocarcinoma: A Meta-Analysis And Literature Review

Background and aim: Increasing evidence indicates that the modified Glasgow Prognostic Score (mGPS) is a useful biomarker of long-term outcomes in various types of cancer. However, its prognostic value in patients with cholangiocarcinoma is not fully investigated. Thus, we investigated its relationship with overall survival (OS) to evaluate its role in predicting survival in patients with cholangiocarcinoma. Methods: PubMed, EMBASE and Web of Science databases were systematically searched to identify studies that evaluated the prognostic impact of the modified Glasgow Prognostic Score (mGPS) in cholangiocarcinoma patients. Meta-analysis using random-effects model was performed to calculate hazard ratio (HR) and corresponding confidence intervals (CIs) respectively. Results: A total of five studies comprising 1022 patients were included in the meta-analysis, of which overall survival was used as an outcome measure. The results showed that OS was worse in patients with a mGPS = 1 or 2 with a pooled HR of 1.80 (95% CI = 1.48-2.19, P<0.001) than those with a score of 0. The patients with a mGPS = 0 or 1 have significantly prolonged OS compared with those with a score of 2 with a pooled HR of 3.89 (95% CI = 1.70-8.91, P = 0.001). Conclusions: The results of this meta-analysis suggest that higher mGPS is associated with poorer survival in patients with cholangiocarcinoma. More well-designed studies are necessary to provide solid data to confirm the prognostic significance of mGPS.