| Objective To investigate the relationship between the Glasgow prognostic score(GPS)and the prognosis of pancreatic cancer by systematic review and trial sequential analysis(TSA).Methods PubMed,Cochrane Library,CNKI and Wanfang database were systematically searched from the date of creation to March 25,2019.Prospective or retrospective cohort studies focused on correlation between GPS and pancreatic cancer prognosis were included according to the inclusion and exclusion criteria.We used Stata software,version 12.0 and R software,version 3.6.0 to conduct the Meta-analysis.Hazard ratio(HR)and 95% confidence interval(95% CI)were used as the effect measures.Subgroup analysis,publication bias,sensitivity analysis and trial sequential analysis were also performed.Results 426 articles in Chinese and English were reached at the beginning,and a total of 11 articles involving 12 cohorts and 1968 patients diagnosed with pancreatic cancer were included according to the inclusion and exclusion criteria in the end.The results of Meta-analysis showed that pancreatic cancer patients with high GPS score had worse overall survival(OS)and progression free survival(PFS)(OS: HR=2.042,95% CI 1.538~2.711,P<0.001;PFS: HR=3.255,95% CI 2.005~5.285,P<0.001).Subgroup analysis showed that patients with high GPS score had a worse prognosis in studies of different races and sample sizes.The prognosis of patients in the non-surgical treatment group and the surgery +adjuvant therapy group was associated with GPS,while the prognosis of the patients in the surgery group was not.Both Begg’s and Egger’s tests indicated no significant publication bias between included studies.Sensitivity analysis showed that the results of this study werestable.The results of TSA showed that although the data collected in this study did not achieve the required information size,the results of the Meta-analysis were truly positive according to the adjustment threshold.The conclusions were reliable,and the probability of false positive was small.Conclusions High GPS score in patients with pancreatic cancer suggests that patients have worse prognosis.GPS can be used as a reliable and effective predictor of clinical prognosis. |
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