Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia
Abstract Background The development and progression of cancer cachexia are connected to systemic inflammation and physical performance. However, few relevant studies have reported the survival outcomes prediction of systemic inflammation and physical performance in patients with colorectal cancer (C...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.13358 |
| _version_ | 1797375113965862912 |
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| author | Guo‐Tian Ruan Hai‐Lun Xie Kai‐Tao Yuan Shi‐Qi Lin He‐Yang Zhang Chen‐An Liu Jin‐Yu Shi Yi‐Zhong Ge Meng‐Meng Song Chun‐Lei Hu Xiao‐Wei Zhang Xiao‐Yue Liu Ming Yang Kun‐Hua Wang Xin Zheng Yue Chen Wen Hu Ming‐Hua Cong Li‐Chen Zhu Li Deng Han‐Ping Shi |
| author_facet | Guo‐Tian Ruan Hai‐Lun Xie Kai‐Tao Yuan Shi‐Qi Lin He‐Yang Zhang Chen‐An Liu Jin‐Yu Shi Yi‐Zhong Ge Meng‐Meng Song Chun‐Lei Hu Xiao‐Wei Zhang Xiao‐Yue Liu Ming Yang Kun‐Hua Wang Xin Zheng Yue Chen Wen Hu Ming‐Hua Cong Li‐Chen Zhu Li Deng Han‐Ping Shi |
| author_sort | Guo‐Tian Ruan |
| collection | DOAJ |
| description | Abstract Background The development and progression of cancer cachexia are connected to systemic inflammation and physical performance. However, few relevant studies have reported the survival outcomes prediction of systemic inflammation and physical performance in patients with colorectal cancer (CRC) cachexia. This study investigated the prognostic prediction value of systemic inflammation and performance status in patients with CRC cachexia. Methods This multicentre cohort study prospectively collected 905 patients with CRC (58.3% males, 59.3 ± 11.5 years old). Cancer cachexia was diagnosed according to the 2011 Fearon Cachexia Diagnostic Consensus. The prognostic value of systematic inflammatory indicators was determined using the area under the curve, concordance index, and multivariate survival analysis. Performance status was evaluated with Eastern Coopertive Oncology Group performance score (ECOG‐PS). Survival data were analysed using univariate and multivariate Cox regression analyses. Results The area under the curve, concordance index and survival analysis showed that C‐reactive protein (CRP), lymphocyte to CRP ratio (LCR) and CRP to albumin ratio (CAR) were more stable and consistent with the survival of patients with CRC, both in non‐cachexia and cachexia populations. Among patients with CRC cachexia, high inflammation [low LCR, hazard ratio (HR) 95% confidence interval (95% CI) = 3.33 (2.08–5.32); high CAR, HR (95% CI) = 2.92 (1.88–4.55); high CRP, HR (95% CI) = 3.12 (2.08–4.67)] indicated a worse prognosis, compared with non‐cachexia patients [low LCR, HR (95% CI) = 2.28 (1.65–3.16); high CAR, HR (95% CI) = 2.36 (1.71–3.25); high CRP, HR (95% CI) = 2.58 (1.85–3.60)]. Similarly, among patients with CRC cachexia, high PS [ECOG‐PS 2, HR (95% CI) = 1.61 (1.04–2.50); ECOG‐PS 3/4, HR (95% CI) = 2.91 (1.69–5.00]) indicated a worse prognosis, compared with patients with CRC without cachexia [ECOG‐PS 2, HR (95% CI) = 1.28 (0.90–1.81); ECOG‐PS 3/4, HR (95% CI) = 2.41 (1.32–4.39]). Patients with CRC cachexia with an ECOG‐PS score of 2 or 3–4 and a high inflammation had a shorter median survival time, compared with patients with an ECOG‐PS score of 0/1 and a low inflammation. Conclusions The systemic inflammatory markers LCR, CAR and CRP have stable prognostic values in patients with CRC. The ECOG‐PS may be an independent risk factor for CRC. Combined evaluation of systemic inflammation and ECOG‐PS in patients with CRC cachexia could provide a simple survival prediction. |
| first_indexed | 2024-03-08T19:17:32Z |
| format | Article |
| id | doaj.art-6e6af16cbff14f53a4a14c419e66876f |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-03-08T19:17:32Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-6e6af16cbff14f53a4a14c419e66876f2023-12-27T05:05:03ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092023-12-011462813282310.1002/jcsm.13358Prognostic value of systemic inflammation and for patients with colorectal cancer cachexiaGuo‐Tian Ruan0Hai‐Lun Xie1Kai‐Tao Yuan2Shi‐Qi Lin3He‐Yang Zhang4Chen‐An Liu5Jin‐Yu Shi6Yi‐Zhong Ge7Meng‐Meng Song8Chun‐Lei Hu9Xiao‐Wei Zhang10Xiao‐Yue Liu11Ming Yang12Kun‐Hua Wang13Xin Zheng14Yue Chen15Wen Hu16Ming‐Hua Cong17Li‐Chen Zhu18Li Deng19Han‐Ping Shi20Department 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 ChinaCenter of Gastrointestinal Surgery, The First Affiliated Hospital Sun Yat‐sen University Guangzhou 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 ChinaYunnan University Kunming 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 Clinical Nutrition Sichuan University West China Hospital Chengdu ChinaDepartment of Comprehensive Oncology, National Cancer Center/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing ChinaDepartment of Immunology, School of Preclinical Medicine 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 ChinaAbstract Background The development and progression of cancer cachexia are connected to systemic inflammation and physical performance. However, few relevant studies have reported the survival outcomes prediction of systemic inflammation and physical performance in patients with colorectal cancer (CRC) cachexia. This study investigated the prognostic prediction value of systemic inflammation and performance status in patients with CRC cachexia. Methods This multicentre cohort study prospectively collected 905 patients with CRC (58.3% males, 59.3 ± 11.5 years old). Cancer cachexia was diagnosed according to the 2011 Fearon Cachexia Diagnostic Consensus. The prognostic value of systematic inflammatory indicators was determined using the area under the curve, concordance index, and multivariate survival analysis. Performance status was evaluated with Eastern Coopertive Oncology Group performance score (ECOG‐PS). Survival data were analysed using univariate and multivariate Cox regression analyses. Results The area under the curve, concordance index and survival analysis showed that C‐reactive protein (CRP), lymphocyte to CRP ratio (LCR) and CRP to albumin ratio (CAR) were more stable and consistent with the survival of patients with CRC, both in non‐cachexia and cachexia populations. Among patients with CRC cachexia, high inflammation [low LCR, hazard ratio (HR) 95% confidence interval (95% CI) = 3.33 (2.08–5.32); high CAR, HR (95% CI) = 2.92 (1.88–4.55); high CRP, HR (95% CI) = 3.12 (2.08–4.67)] indicated a worse prognosis, compared with non‐cachexia patients [low LCR, HR (95% CI) = 2.28 (1.65–3.16); high CAR, HR (95% CI) = 2.36 (1.71–3.25); high CRP, HR (95% CI) = 2.58 (1.85–3.60)]. Similarly, among patients with CRC cachexia, high PS [ECOG‐PS 2, HR (95% CI) = 1.61 (1.04–2.50); ECOG‐PS 3/4, HR (95% CI) = 2.91 (1.69–5.00]) indicated a worse prognosis, compared with patients with CRC without cachexia [ECOG‐PS 2, HR (95% CI) = 1.28 (0.90–1.81); ECOG‐PS 3/4, HR (95% CI) = 2.41 (1.32–4.39]). Patients with CRC cachexia with an ECOG‐PS score of 2 or 3–4 and a high inflammation had a shorter median survival time, compared with patients with an ECOG‐PS score of 0/1 and a low inflammation. Conclusions The systemic inflammatory markers LCR, CAR and CRP have stable prognostic values in patients with CRC. The ECOG‐PS may be an independent risk factor for CRC. Combined evaluation of systemic inflammation and ECOG‐PS in patients with CRC cachexia could provide a simple survival prediction.https://doi.org/10.1002/jcsm.13358CachexiaCRCECOG‐PSSystemic inflammation |
| spellingShingle | Guo‐Tian Ruan Hai‐Lun Xie Kai‐Tao Yuan Shi‐Qi Lin He‐Yang Zhang Chen‐An Liu Jin‐Yu Shi Yi‐Zhong Ge Meng‐Meng Song Chun‐Lei Hu Xiao‐Wei Zhang Xiao‐Yue Liu Ming Yang Kun‐Hua Wang Xin Zheng Yue Chen Wen Hu Ming‐Hua Cong Li‐Chen Zhu Li Deng Han‐Ping Shi Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia Journal of Cachexia, Sarcopenia and Muscle Cachexia CRC ECOG‐PS Systemic inflammation |
| title | Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| title_full | Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| title_fullStr | Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| title_full_unstemmed | Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| title_short | Prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| title_sort | prognostic value of systemic inflammation and for patients with colorectal cancer cachexia |
| topic | Cachexia CRC ECOG‐PS Systemic inflammation |
| url | https://doi.org/10.1002/jcsm.13358 |
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