Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study
BackgroundCurrent diagnostic criteria for cancer cachexia are inconsistent, and arguments still exist about the impact of cachexia on the survival of patients with colorectal cancer. In this study, we aim to investigate the prognostic value of a novel cachexia indicator, the cachexia index (CXI), in...
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| Format: | Article |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.984459/full |
| _version_ | 1818058005679177728 |
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| author | Qianyi Wan Qian Yuan Rui Zhao Xiaoding Shen Yi Chen Tao Li Yinghan Song |
| author_facet | Qianyi Wan Qian Yuan Rui Zhao Xiaoding Shen Yi Chen Tao Li Yinghan Song |
| author_sort | Qianyi Wan |
| collection | DOAJ |
| description | BackgroundCurrent diagnostic criteria for cancer cachexia are inconsistent, and arguments still exist about the impact of cachexia on the survival of patients with colorectal cancer. In this study, we aim to investigate the prognostic value of a novel cachexia indicator, the cachexia index (CXI), in patients with colorectal cancer.MethodsThe CXI was calculated as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio. The cut-off value of CXI was determined by the receiver operating characteristic (ROC) curves and Youden’s index. The major outcomes were major complications, overall survival (OS), and recurrence-free survival (RFS).ResultsA total of 379 patients (234 men and 145 women) were included. The ROC curves indicated that CXI had a significantly diagnostic capacity for the detection of major complications. Based on Youden’s index, there were 231 and 148 patients in the low and high CXI groups, respectively. Patients in the low CXI group had significantly older age, lower BMI, and a higher percentage of cachexia and TNM stage II+III. Besides, Patients in low CXI group were associated with a significantly higher rate of major complications, blood transfusion, and longer length of stay. Logistic regression analysis indicated that low CXI, cachexia, and coronary heart disease were independent risk factors for the major complications. Kaplan Meier survival curves indicated that patients with high CXI had a significantly more favorable OS than those with low CXI, while no significant difference was found in RFS between the two groups. Besides, there were no significant differences in OS or RFS between patients with and without cachexia. The univariate and multivariate Cox regression analysis indicated that older age, low CXI, and coronary heart disease instead of cachexia were associated with a decreased OS.ConclusionCXI was better than cachexia in predicting OS and could be a useful prognostic indicator in patients with colorectal cancer, and greater attention should be paid to patients with low CXI. |
| first_indexed | 2024-12-10T12:53:45Z |
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| id | doaj.art-76bd35a936ad4c70bb44a4e510b7c40a |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T12:53:45Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-76bd35a936ad4c70bb44a4e510b7c40a2022-12-22T01:48:10ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-09-011210.3389/fonc.2022.984459984459Prognostic value of cachexia index in patients with colorectal cancer: A retrospective studyQianyi Wan0Qian Yuan1Rui Zhao2Xiaoding Shen3Yi Chen4Tao Li5Yinghan Song6Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, ChinaOperating Room of Anesthesia Surgery Center, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, ChinaLaboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of day surgery center, West China Hospital, Sichuan University, Chengdu, ChinaBackgroundCurrent diagnostic criteria for cancer cachexia are inconsistent, and arguments still exist about the impact of cachexia on the survival of patients with colorectal cancer. In this study, we aim to investigate the prognostic value of a novel cachexia indicator, the cachexia index (CXI), in patients with colorectal cancer.MethodsThe CXI was calculated as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio. The cut-off value of CXI was determined by the receiver operating characteristic (ROC) curves and Youden’s index. The major outcomes were major complications, overall survival (OS), and recurrence-free survival (RFS).ResultsA total of 379 patients (234 men and 145 women) were included. The ROC curves indicated that CXI had a significantly diagnostic capacity for the detection of major complications. Based on Youden’s index, there were 231 and 148 patients in the low and high CXI groups, respectively. Patients in the low CXI group had significantly older age, lower BMI, and a higher percentage of cachexia and TNM stage II+III. Besides, Patients in low CXI group were associated with a significantly higher rate of major complications, blood transfusion, and longer length of stay. Logistic regression analysis indicated that low CXI, cachexia, and coronary heart disease were independent risk factors for the major complications. Kaplan Meier survival curves indicated that patients with high CXI had a significantly more favorable OS than those with low CXI, while no significant difference was found in RFS between the two groups. Besides, there were no significant differences in OS or RFS between patients with and without cachexia. The univariate and multivariate Cox regression analysis indicated that older age, low CXI, and coronary heart disease instead of cachexia were associated with a decreased OS.ConclusionCXI was better than cachexia in predicting OS and could be a useful prognostic indicator in patients with colorectal cancer, and greater attention should be paid to patients with low CXI.https://www.frontiersin.org/articles/10.3389/fonc.2022.984459/fullcolorectal cancercachexia indexcancer cachexiamajor complicationsoverall survival |
| spellingShingle | Qianyi Wan Qian Yuan Rui Zhao Xiaoding Shen Yi Chen Tao Li Yinghan Song Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study Frontiers in Oncology colorectal cancer cachexia index cancer cachexia major complications overall survival |
| title | Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study |
| title_full | Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study |
| title_fullStr | Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study |
| title_full_unstemmed | Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study |
| title_short | Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study |
| title_sort | prognostic value of cachexia index in patients with colorectal cancer a retrospective study |
| topic | colorectal cancer cachexia index cancer cachexia major complications overall survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.984459/full |
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