Supplementary Material for: Modified Glasgow prognostic score as a marker for predicting outcomes in patients with either bladder and prostate cancer : A systematic review and meta-analysis

Objective: To investigate the association of pretreatment-modified Glasgow Prognostic Score (mGPS) with survival-related outcomes in patients with bladder cancer (BC) and prostate cancer (PC). Methods: A systematic search was performed in PubMed, EMBASE, Web of Science, and Scopus databases for cohort studies in adult participants (≥18 years). The exposure was pre-treatment mGPS and the outcomes of interest were overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). Eligible studies compared low mGPS (considered as a score of 0) with a score of ≥1. A random effects model was used for the analysis. Pooled effect sizes were reported as hazard ratio (HR) with 95% confidence intervals (CI). Subgroup analysis was performed based on the tumour stage (≤T2 and >T2), sample size (≥200 and <200), treatment (surgical and non-surgical), and the Newcastle-Ottawa Scale (NOS) score (≥8 and ≤7). Results: Of 20 studies. Included in the analysis, 19 studies were retrospective cohort studies. Fourteen studies reported data of patients with BC, and the remaining 6 studies focused on PC patients. Compared to mGPS of 0, higher scores were associated with reduced OS (HR 2.65, 95% CI: 1.99, 3.52), CSS (HR 1.64, 95% CI: 1.19, 2.26), and RFS (HR 1.77, 95% CI: 1.50, 2.08). There was no evidence of publication bias (Egger’s p>0.05). These associations remained valid in subgroup analysis. Conclusion: Higher mGPS values were found to be associated with significantly reduced survival outcomes. These findings underscore the prognostic significance of mGPS, thereby highlighting its potential clinical utility in risk stratification and treatment decision-making.