Predictive Value of the Glasgow Prognostic Score for Prognosis in Patients with Hypopharyngeal Squamous Cell Carcinoma Treated with Curative Radiotherapy

TL;DR

This study shows that the Glasgow Prognostic Score helps predict survival in hypopharyngeal cancer patients treated with radiotherapy.

Contribution

The study demonstrates GPS as an independent prognostic tool in hypopharyngeal squamous cell carcinoma.

Findings

Higher GPS scores correlated with worse 3-year overall survival in HPSCC patients.

GPS remained an independent predictor of worse OS alongside poor performance status and advanced stage.

GPS could help identify high-risk patients for more intensive treatment.

Abstract

Background/Objectives: Hypopharyngeal squamous cell carcinoma (HPSCC) carries a poor prognosis, and reliable, inexpensive biomarkers are needed to refine risk-stratified treatment. The Glasgow Prognostic Score (GPS), integrating C-reactive protein and albumin, reflects systemic inflammation and nutritional status, but its prognostic utility in curative radiotherapy for HPSCC remains unclear. Methods: We retrospectively reviewed 98 consecutive patients with pathologically confirmed HPSCC who received definitive tomotherapy (70 Gy in 35 fractions) from June 2015 to February 2024 at a single tertiary center. Pretreatment GPS was classified as 0–2. Overall survival (OS) and progression-free survival (PFS) were assessed by Cox proportional hazards models, which evaluated associations between GPS and other clinical parameters. Results: Median age was 68 years (range 41–89); 92% were male. GPS distribution was 0 in 74 patients (76%), 1 in 18 (18%), and 2 in 6 (6%). After a median follow-up of 36.2 months, 3-year OS and PFS for the whole cohort were 78.7% and 51.7%, respectively. Patients with GPS 0 showed significantly higher 3-year OS than those with GPS 1–2 (83.6% vs. 62.2%; p = 0.023). On multivariate analysis, elevated GPS (1–2) remained an independent predictor of worse OS (hazard ratio [HR] 2.62, 95% CI 1.03–6.70; p = 0.044) alongside poor performance status and advanced stage. Conclusions: Pretreatment GPS independently stratifies overall survival in HPSCC patients undergoing curative radiotherapy, complementing established clinical factors. Because CRP and albumin are routinely available, GPS may assist in identifying high-risk patients who could benefit from intensified multidisciplinary treatment. Prospective multicenter studies are warranted to validate these findings.

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