# 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.

## Key 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.