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Modified Glasgow prognostic score as a prognostic indicator of hepatocellular carcinoma: a systematic review and meta-analysis

evidence-based-medicine
gastroenterology-and-hepatology
oncology

Abstract

Objective: This review was conducted to examine whether a modified Glasgow Prognostic Score (mGPS) can be used to predict the prognosis of hepatocellular carcinoma (HCC).

Methods: Two reviewers explored the databases of PubMed, CENTRAL, Scopus, Web of Science, and Embase for studies examining overall survival (OS) and disease-free survival (DFS) in HCC based on mGPS. The search concluded on 15 October 2024.

Results: Nine studies with eleven cohorts were included. Comparing the mGPS score of ≥1 with zero, the meta-analysis showed that high mGPS was a significant predictor of OS in HCC (HR: 1.71, 95% CI: 1.23, 2.36, I 2 =75%). Likewise, the meta-analysis showed that an mGPS score of 2 was associated with statistically significant poor OS as compared to those with a score of zero (HR: 1.97, 95% CI: 1.53, 2.54, I²=0%). DFS was reported by only three studies. Pooled analysis showed that the mGPS score of ≥1 was not predictive of poor DFS (HR: 1.77, 95% CI: 0.81, 3.86 I 2 =81%). No publication bias was noted, and results did not change in the sensitivity analysis. Subgroup analysis for OS based on location, sample size, percentage of hepatitis B+ve, Child-Pugh class B/C, BCLC stage B and above, treatment, and study quality showed mixed results.

Conclusions: mGPS can be used to predict OS in patients with HCC. However, its utility for predicting DFS remains unproven. Further studies are needed to complement the present evidence.

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