Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study
The current diagnostic criteria for cancer cachexia are inconsistent, and the prognostic value of cachexia in gastric cancer (GC) is controversial. This study aimed to investigate the prognostic value of the cachexia index (CXI) in patients with GC. We calculated the CXI as skeletal muscle index (SM...
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MDPI AG
2022-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/18/4400 |
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| author | Can Gong Qianyi Wan Rui Zhao Xinrong Zuo Yi Chen Tao Li |
| author_facet | Can Gong Qianyi Wan Rui Zhao Xinrong Zuo Yi Chen Tao Li |
| author_sort | Can Gong |
| collection | DOAJ |
| description | The current diagnostic criteria for cancer cachexia are inconsistent, and the prognostic value of cachexia in gastric cancer (GC) is controversial. This study aimed to investigate the prognostic value of the cachexia index (CXI) in patients with GC. We calculated the CXI as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio (NLR), and a total of 161 and 163 patients were included in the high and low CXI groups, respectively. Low CXI was significantly associated with a more advanced tumor–node–metastasis (TNM) stage, a higher level of serum C-reactive protein, serum interleukin-6, and NLR, but also a decreased level of serum prealbumin and albumin. In addition, patients in the low CXI group were more likely to have postoperative pulmonary infections (9.8% vs. 3.7%, <i>p</i> = 0.03). Cox proportional analyses indicated that patients with low CXI (HR 0.45, 95% CI 0.29 to 0.69; <i>p</i> < 0.001) or TNM stage III+IV (HR 4.38, 95% CI 2.54 to 7.55; <i>p</i> < 0.001) had a significantly poorer overall survival (OS). Kaplan–Meier survival curves suggested that patients with low CXI had a significantly decreased OS, which was not affected by subgroup analyses of different sex, age, cachexia, body mass index (BMI), and TNM stage. Furthermore, low CXI combined with cachexia, low BMI, or TNM stage III+IV caused the worst OS in each subgroup analysis, respectively. Our study demonstrated that CXI had a good prognostic value in GC. Greater attention should be paid to patients with low CXI, particularly those combined with cachexia, low BMI, or TNM stage III+IV. |
| first_indexed | 2024-03-10T00:30:55Z |
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| id | doaj.art-cccb51606df14311937a3b9d951a2cc4 |
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| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T00:30:55Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-cccb51606df14311937a3b9d951a2cc42023-11-23T15:26:38ZengMDPI AGCancers2072-66942022-09-011418440010.3390/cancers14184400Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective StudyCan Gong0Qianyi Wan1Rui Zhao2Xinrong Zuo3Yi Chen4Tao Li5Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaDepartment of Anesthesiology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, ChinaDepartment of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, ChinaLaboratory of Mitochondria and Metabolism, Department of Anesthesiology, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, ChinaThe current diagnostic criteria for cancer cachexia are inconsistent, and the prognostic value of cachexia in gastric cancer (GC) is controversial. This study aimed to investigate the prognostic value of the cachexia index (CXI) in patients with GC. We calculated the CXI as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio (NLR), and a total of 161 and 163 patients were included in the high and low CXI groups, respectively. Low CXI was significantly associated with a more advanced tumor–node–metastasis (TNM) stage, a higher level of serum C-reactive protein, serum interleukin-6, and NLR, but also a decreased level of serum prealbumin and albumin. In addition, patients in the low CXI group were more likely to have postoperative pulmonary infections (9.8% vs. 3.7%, <i>p</i> = 0.03). Cox proportional analyses indicated that patients with low CXI (HR 0.45, 95% CI 0.29 to 0.69; <i>p</i> < 0.001) or TNM stage III+IV (HR 4.38, 95% CI 2.54 to 7.55; <i>p</i> < 0.001) had a significantly poorer overall survival (OS). Kaplan–Meier survival curves suggested that patients with low CXI had a significantly decreased OS, which was not affected by subgroup analyses of different sex, age, cachexia, body mass index (BMI), and TNM stage. Furthermore, low CXI combined with cachexia, low BMI, or TNM stage III+IV caused the worst OS in each subgroup analysis, respectively. Our study demonstrated that CXI had a good prognostic value in GC. Greater attention should be paid to patients with low CXI, particularly those combined with cachexia, low BMI, or TNM stage III+IV.https://www.mdpi.com/2072-6694/14/18/4400gastric cancercachexia indexcancer cachexiaoverall survival |
| spellingShingle | Can Gong Qianyi Wan Rui Zhao Xinrong Zuo Yi Chen Tao Li Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study Cancers gastric cancer cachexia index cancer cachexia overall survival |
| title | Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study |
| title_full | Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study |
| title_fullStr | Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study |
| title_full_unstemmed | Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study |
| title_short | Cachexia Index as a Prognostic Indicator in Patients with Gastric Cancer: A Retrospective Study |
| title_sort | cachexia index as a prognostic indicator in patients with gastric cancer a retrospective study |
| topic | gastric cancer cachexia index cancer cachexia overall survival |
| url | https://www.mdpi.com/2072-6694/14/18/4400 |
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