*5.2.4. TNM stage*

**Group Score Target References**

224 GPS OS [24]

68 GPS OS [103]

256 mGPS OS [26]

42 mGPS CSS [99]

91 GPS OS [105]

384 GPS OS [68]

125 GPS OS [104]

104 mGPS OS [69]

83 GPS CSS, PFS [102]

90 (30 vs. 30 vs. 30) GPS Cachexia, adipokines [107]

71 GPS Predicting metastasis [108]

Abbreviations: GC, gastric cancer; mGPS, modified Glasgow prognostic score; OS, overall survival; GPS, Glasgow prognostic score; T, local tumour spread by tumour-nodes-metastasis (TNM) classification; M, presence of distant metastasis by TNM classification; R, resection line status; CEA, carcinoembryonic protein; HS-GPS, high sensitivity Glasgow prognostic score; CFS, cancer-free survival; CSS; cancer-free survival; PFS, progression-free survival; TNM,

tumour-nodes-metastasis classification; vs, versus; N, regional lymph node status by TNM classification.

**Table 5.** The design of studies devoted to Glasgow prognostic score in gastric cancer.

OS

[101]

402 GPS PFS

**Characteristics Size Original studies of advanced GC**

Chemotherapy for advanced GC

176 Gastric Cancer

Advanced GC treated with chemo- or chemoradiotherapy

Metastatic GC treated by

GC patients at stage IV, treated by palliative

Inoperable advanced or metastatic GC patients receiving first-line chemotherapy

Advanced GC patients treated by single agent palliative chemotherapy due to poor performance

Metastatic GC treated by palliative chemotherapy

Advanced GC treated by

Advanced recurrent or metastatic GC patients receiving first-line palliative chemotherapy

GC patients with vs. without cachexia vs.

Inoperable GC subjected to chemotherapy

controls

chemotherapy

chemotherapy

gastrectomy

Metastatic or recurrent GC patients considered for palliative chemotherapy

Assessing 1710 patients with gastric cancer, modified GPS was associated with advanced stage [94]. Elevated GPS has been reported in gastric cancer patients having cachexia; higher stage was also observed in cachectic patients [107]. However, GPS did not differ between metastatic and non-metastatic gastric cancer cases. Although the study group was small consisting of only 43 metastatic and 28 non-metastatic cases, a novel score based on pre-albumin and CRP, showed significant differences [108]. In a recent meta-analysis including 14 studies and 5579 gastric cancer patients, elevated GPS was significantly associated with high TNM stage (odds ratio 3.09; 95% CI = 2.11–4.53) as reported by Zhang et al. [106].
