Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study
Abstract Background Although systemic inflammation is an important feature of the cancer cachexia, studies on the association between systemic inflammation and prognostic of cancer cachexia are limited. The objective of this study is to evaluate whether the neutrophil‐to‐lymphocyte ratio (NLR) is as...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12761 |
| _version_ | 1797203904629309440 |
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| author | Qi Zhang Meng‐Meng Song Xi Zhang Jia‐Shan Ding Guo‐Tian Ruan Xiao‐Wei Zhang Tong Liu Ming Yang Yi‐Zhong Ge Meng Tang Xiang‐Rui Li Liang Qian Chun‐Hua Song Hong‐Xia Xu Han‐Ping Shi |
| author_facet | Qi Zhang Meng‐Meng Song Xi Zhang Jia‐Shan Ding Guo‐Tian Ruan Xiao‐Wei Zhang Tong Liu Ming Yang Yi‐Zhong Ge Meng Tang Xiang‐Rui Li Liang Qian Chun‐Hua Song Hong‐Xia Xu Han‐Ping Shi |
| author_sort | Qi Zhang |
| collection | DOAJ |
| description | Abstract Background Although systemic inflammation is an important feature of the cancer cachexia, studies on the association between systemic inflammation and prognostic of cancer cachexia are limited. The objective of this study is to evaluate whether the neutrophil‐to‐lymphocyte ratio (NLR) is associated with outcome and quality of life for patients with cancer cachexia and investigated any interaction between NLR and the clinical parameters. Methods This is a multicentre cohort study of 2612 cancer patients suffering from cachexia diagnosed between June 2012 and December 2019. The main parameters measured were overall survival (OS) time and all‐cause mortality. The association between NLR and all‐cause mortality was evaluated using hazard ratios (HRs) and the restricted cubic spline model with a two‐sided P‐value. Optimal stratification was used to solve threshold points. We also evaluated the cross‐classification of NLR for each variable of survival. Results Of the 2612 participants diagnosed with cancer cachexia, 1533 (58.7%) were male, and the mean (SD) age was 58.7 (11.7) years. Over a median follow‐up of 4.5 years, we observed 1189 deaths. The overall mortality rate for patients with cancer cachexia during the first 12 months was 30.2% (95%CI: 28.4%–32.0%), resulting in a rate of 226.07 events per 1000 patient‐years. An increase in NLR had an inverted L‐shaped dose–response association with all‐cause mortality. The optimal cut‐off point for NLR as a predictor of mortality in cancer patients with cachexia was 3.5. An NLR of 3.5 or greater could independently predict OS (HR, 1.51, 95%CI: 1.33–1.71). These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified including gender, BMI, tumour type, KPS score and albumin in content. Increasing NLRs were independently associated with a worsening in the majority of EORTC QLQ‐C30 domains. Elevated baseline NLR was associated with low response and poor survival in patients treated with immunotherapy. Conclusions The baseline NLR status was found to be a significant negative prognostic biomarker for patients with cachexia; this effect was independent of other known prognostic factors. |
| first_indexed | 2024-04-24T08:26:45Z |
| format | Article |
| id | doaj.art-3cf5691431944489b7a471768f12d8c7 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-24T08:26:45Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-3cf5691431944489b7a471768f12d8c72024-04-16T21:54:10ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-12-011261466147610.1002/jcsm.12761Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort studyQi Zhang0Meng‐Meng Song1Xi Zhang2Jia‐Shan Ding3Guo‐Tian Ruan4Xiao‐Wei Zhang5Tong Liu6Ming Yang7Yi‐Zhong Ge8Meng Tang9Xiang‐Rui Li10Liang Qian11Chun‐Hua Song12Hong‐Xia Xu13Han‐Ping Shi14Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Obstetrics and Gynecology First Affiliated Hospital of Nanchang University Nanchang ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaThe Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University Wenzhou ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaDepartment of Gynecology Hangzhou Women's Hospital Hangzhou ChinaDepartment of Epidemiology, College of Public Health Zhengzhou University Zhengzhou ChinaDepartment of Clinical Nutrition, Daping Hospital Army Medical University Chongqing ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaAbstract Background Although systemic inflammation is an important feature of the cancer cachexia, studies on the association between systemic inflammation and prognostic of cancer cachexia are limited. The objective of this study is to evaluate whether the neutrophil‐to‐lymphocyte ratio (NLR) is associated with outcome and quality of life for patients with cancer cachexia and investigated any interaction between NLR and the clinical parameters. Methods This is a multicentre cohort study of 2612 cancer patients suffering from cachexia diagnosed between June 2012 and December 2019. The main parameters measured were overall survival (OS) time and all‐cause mortality. The association between NLR and all‐cause mortality was evaluated using hazard ratios (HRs) and the restricted cubic spline model with a two‐sided P‐value. Optimal stratification was used to solve threshold points. We also evaluated the cross‐classification of NLR for each variable of survival. Results Of the 2612 participants diagnosed with cancer cachexia, 1533 (58.7%) were male, and the mean (SD) age was 58.7 (11.7) years. Over a median follow‐up of 4.5 years, we observed 1189 deaths. The overall mortality rate for patients with cancer cachexia during the first 12 months was 30.2% (95%CI: 28.4%–32.0%), resulting in a rate of 226.07 events per 1000 patient‐years. An increase in NLR had an inverted L‐shaped dose–response association with all‐cause mortality. The optimal cut‐off point for NLR as a predictor of mortality in cancer patients with cachexia was 3.5. An NLR of 3.5 or greater could independently predict OS (HR, 1.51, 95%CI: 1.33–1.71). These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified including gender, BMI, tumour type, KPS score and albumin in content. Increasing NLRs were independently associated with a worsening in the majority of EORTC QLQ‐C30 domains. Elevated baseline NLR was associated with low response and poor survival in patients treated with immunotherapy. Conclusions The baseline NLR status was found to be a significant negative prognostic biomarker for patients with cachexia; this effect was independent of other known prognostic factors.https://doi.org/10.1002/jcsm.12761Systemic inflammationCachexiaNeutrophil‐to‐lymphocyte ratioPrognostic |
| spellingShingle | Qi Zhang Meng‐Meng Song Xi Zhang Jia‐Shan Ding Guo‐Tian Ruan Xiao‐Wei Zhang Tong Liu Ming Yang Yi‐Zhong Ge Meng Tang Xiang‐Rui Li Liang Qian Chun‐Hua Song Hong‐Xia Xu Han‐Ping Shi Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study Journal of Cachexia, Sarcopenia and Muscle Systemic inflammation Cachexia Neutrophil‐to‐lymphocyte ratio Prognostic |
| title | Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study |
| title_full | Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study |
| title_fullStr | Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study |
| title_full_unstemmed | Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study |
| title_short | Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study |
| title_sort | association of systemic inflammation with survival in patients with cancer cachexia results from a multicentre cohort study |
| topic | Systemic inflammation Cachexia Neutrophil‐to‐lymphocyte ratio Prognostic |
| url | https://doi.org/10.1002/jcsm.12761 |
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