The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia
Abstract Background Changes in body composition and systemic inflammation are important characteristics of cancer cachexia. This multi‐centre retrospective study aimed to explore the prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia. M...
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.13205 |
| _version_ | 1797854136791728128 |
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| author | Hai‐Lun Xie Guo‐Tian Ruan Lishuang Wei Qi Zhang Yi‐Zhong Ge Meng‐Meng Song Xi Zhang Shi‐qi Lin Xiao‐yue Liu Xiao‐Wei Zhang Xiang‐Rui Li Kang‐Ping Zhang Chun‐Lei Hu Ming Yang Meng Tang Chun‐Hua Song Ming‐Hua Cong Min Weng Zeng‐Ning Li Wei Li Kun‐Hua Wang Han‐Ping Shi |
| author_facet | Hai‐Lun Xie Guo‐Tian Ruan Lishuang Wei Qi Zhang Yi‐Zhong Ge Meng‐Meng Song Xi Zhang Shi‐qi Lin Xiao‐yue Liu Xiao‐Wei Zhang Xiang‐Rui Li Kang‐Ping Zhang Chun‐Lei Hu Ming Yang Meng Tang Chun‐Hua Song Ming‐Hua Cong Min Weng Zeng‐Ning Li Wei Li Kun‐Hua Wang Han‐Ping Shi |
| author_sort | Hai‐Lun Xie |
| collection | DOAJ |
| description | Abstract Background Changes in body composition and systemic inflammation are important characteristics of cancer cachexia. This multi‐centre retrospective study aimed to explore the prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia. Methods The modified advanced lung cancer inflammation index (mALI), which combines body composition and systemic inflammation, was defined as appendicular skeletal muscle index (ASMI) × serum albumin/neutrophil‐lymphocyte ratio. The ASMI was estimated according to a previously validated anthropometric equation. Restricted cubic splines were used to evaluate the relationship between mALI and all‐cause mortality in patients with cancer cachexia. Kaplan–Meier analysis and Cox proportional hazard regression analysis were used to evaluate the prognostic value of mALI in cancer cachexia. A receiver operator characteristic curve was used to compare the effectiveness of mALI and nutritional inflammatory indicators in predicting all‐cause mortality in patients with cancer cachexia. Results A total of 2438 patients with cancer cachexia were enrolled, including 1431 males and 1007 females. The sex‐specific optimal cut‐off values of mALI for males and females were 7.12 and 6.52, respectively. There was a non‐linear relationship between mALI and all‐cause mortality in patients with cancer cachexia. Low mALI was significantly associated with poor nutritional status, high tumour burden, and high inflammation. Patients with low mALI had significantly lower overall survival (OS) than those with high mALI (39.5% vs. 65.5%, P < 0.001). In the male population, OS was significantly lower in the low mALI group than in the high group (34.3% vs. 59.2%, P < 0.001). Similar results were also observed in the female population (46.3% vs. 75.0%, P < 0.001). mALI was an independent prognostic factor for patients with cancer cachexia (hazard ratio [HR] = 0.974, 95% confidence interval [CI] = 0.959–0.990, P = 0.001). For every standard deviation [SD] increase in mALI, the risk of poor prognosis for patients with cancer cachexia was reduced by 2.9% (HR = 0.971, 95%CI = 0.943–0.964, P < 0.001) in males and 8.9% (HR = 0.911, 95%CI = 0.893–0.930, P < 0.001) in females. mALI is an effective complement to the traditional Tumour, Lymph Nodes, Metastasis (TNM) staging system for prognosis evaluation and a promising nutritional inflammatory indicator with a better prognostic effect than the most commonly used clinical nutritional inflammatory indicators. Conclusions Low mALI is associated with poor survival in both male and female patients with cancer cachexia and is a practical and valuable prognostic assessment tool. |
| first_indexed | 2024-04-09T20:02:00Z |
| format | Article |
| id | doaj.art-66ffc3514e004322969e2cdc50205858 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-09T20:02:00Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-66ffc3514e004322969e2cdc502058582023-04-03T02:38:50ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092023-04-0114287989010.1002/jcsm.13205The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexiaHai‐Lun Xie0Guo‐Tian Ruan1Lishuang Wei2Qi Zhang3Yi‐Zhong Ge4Meng‐Meng Song5Xi Zhang6Shi‐qi Lin7Xiao‐yue Liu8Xiao‐Wei Zhang9Xiang‐Rui Li10Kang‐Ping Zhang11Chun‐Lei Hu12Ming Yang13Meng Tang14Chun‐Hua Song15Ming‐Hua Cong16Min Weng17Zeng‐Ning Li18Wei Li19Kun‐Hua Wang20Han‐Ping Shi21Department 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 Geriatric Respiratory Disease Ward, the First Affiliated Hospital Guangxi Medical University Nanning 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 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 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 ChinaBeijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition Beijing ChinaDepartment of Epidemiology, College of Public Health Zhengzhou University Zhenzhou ChinaGeneral Department, Cancer Hospital Chinese Academy of Medical Sciences Beijing ChinaDepartment of Clinical Nutrition The First Affiliated Hospital of Kunming Medical University Kunming ChinaDepartment of Clinical Nutrition The First Affiliated Hospital of Hebei Medical University Shijiazhuang ChinaCancer Center The First Hospital of Jilin University Changchun ChinaDepartment of Surgery The First Affiliated Hospital of Kunming Medical University Kunming ChinaDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital Capital Medical University Beijing ChinaAbstract Background Changes in body composition and systemic inflammation are important characteristics of cancer cachexia. This multi‐centre retrospective study aimed to explore the prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia. Methods The modified advanced lung cancer inflammation index (mALI), which combines body composition and systemic inflammation, was defined as appendicular skeletal muscle index (ASMI) × serum albumin/neutrophil‐lymphocyte ratio. The ASMI was estimated according to a previously validated anthropometric equation. Restricted cubic splines were used to evaluate the relationship between mALI and all‐cause mortality in patients with cancer cachexia. Kaplan–Meier analysis and Cox proportional hazard regression analysis were used to evaluate the prognostic value of mALI in cancer cachexia. A receiver operator characteristic curve was used to compare the effectiveness of mALI and nutritional inflammatory indicators in predicting all‐cause mortality in patients with cancer cachexia. Results A total of 2438 patients with cancer cachexia were enrolled, including 1431 males and 1007 females. The sex‐specific optimal cut‐off values of mALI for males and females were 7.12 and 6.52, respectively. There was a non‐linear relationship between mALI and all‐cause mortality in patients with cancer cachexia. Low mALI was significantly associated with poor nutritional status, high tumour burden, and high inflammation. Patients with low mALI had significantly lower overall survival (OS) than those with high mALI (39.5% vs. 65.5%, P < 0.001). In the male population, OS was significantly lower in the low mALI group than in the high group (34.3% vs. 59.2%, P < 0.001). Similar results were also observed in the female population (46.3% vs. 75.0%, P < 0.001). mALI was an independent prognostic factor for patients with cancer cachexia (hazard ratio [HR] = 0.974, 95% confidence interval [CI] = 0.959–0.990, P = 0.001). For every standard deviation [SD] increase in mALI, the risk of poor prognosis for patients with cancer cachexia was reduced by 2.9% (HR = 0.971, 95%CI = 0.943–0.964, P < 0.001) in males and 8.9% (HR = 0.911, 95%CI = 0.893–0.930, P < 0.001) in females. mALI is an effective complement to the traditional Tumour, Lymph Nodes, Metastasis (TNM) staging system for prognosis evaluation and a promising nutritional inflammatory indicator with a better prognostic effect than the most commonly used clinical nutritional inflammatory indicators. Conclusions Low mALI is associated with poor survival in both male and female patients with cancer cachexia and is a practical and valuable prognostic assessment tool.https://doi.org/10.1002/jcsm.13205Body compositionSystemic inflammationCancer cachexiaPrognostic |
| spellingShingle | Hai‐Lun Xie Guo‐Tian Ruan Lishuang Wei Qi Zhang Yi‐Zhong Ge Meng‐Meng Song Xi Zhang Shi‐qi Lin Xiao‐yue Liu Xiao‐Wei Zhang Xiang‐Rui Li Kang‐Ping Zhang Chun‐Lei Hu Ming Yang Meng Tang Chun‐Hua Song Ming‐Hua Cong Min Weng Zeng‐Ning Li Wei Li Kun‐Hua Wang Han‐Ping Shi The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia Journal of Cachexia, Sarcopenia and Muscle Body composition Systemic inflammation Cancer cachexia Prognostic |
| title | The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| title_full | The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| title_fullStr | The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| title_full_unstemmed | The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| title_short | The prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| title_sort | prognostic value of the combination of body composition and systemic inflammation in patients with cancer cachexia |
| topic | Body composition Systemic inflammation Cancer cachexia Prognostic |
| url | https://doi.org/10.1002/jcsm.13205 |
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