*5.2.5. Manifestations of invasive growth*

In a homogeneous group of 88 gastric cancer patients undergoing only surgical treatment, increasing GPS was associated with presence of venous invasion [96]. In a recent meta-analysis including 14 studies and 5579 gastric cancer patients, high GPS was significantly associated with lymphatic (OR 3.04; 95% CI = 2.00–4.62) and venous (OR 3.56; 95% CI = 1.81–6.99) invasion [106]. In a meta-analysis devoted to the modified Glasgow prognostic score, higher rates of lymphatic (OR 2.51; 95% CI = 1.80–3.51) and venous (OR 2.63; 95% CI = 1.35–5.11) invasion were found in patients in whom the score was at least 1 [109].

### **5.3. Meta-analyses of Glasgow prognostic score and its modifications in gastric cancer**

Recently, a meta-analysis was carried including 14 studies and 5579 gastric cancer patients. High GPS was significantly associated with poor overall survival (hazard ratio 1.51; 95% CI 1.37–1.66), and disease-free survival (HR 1.45; 95% CI = 1.26–1.68) as well as with high TNM stage (odds ratio 3.09; 95% CI = 2.11–4.53), N+ (OR 4.60; 95% CI = 3.23–6.56), lymphatic (OR 3.04; 95% CI = 2.00–4.62) and venous (OR 3.56; 95% CI = 1.81–6.99) invasion [106].

In a meta-analysis devoted to the modified Glasgow prognostic score, worse overall survival (odds ratio OR 2.54; 95% CI = 1.62–3.98 for mGPS = 1 and OR 12.02; 95% CI 6.79–21.28 for mGPS = 2), higher rates of lymphatic (OR 2.51; 95% CI = 1.80–3.51) and venous (OR 2.63; 95% CI = 1.35–5.11) invasion were found in patients in whom the score was not zero [109].
