The Relationship between ECOG-PS, mGPS, BMI/WL Grade and Body Composition and Physical Function in Patients with Advanced Cancer

Dolan, Ross D.; Daly, Louise; Simmons, Claribel; Ryan, Aoife M.; Sim, Wei; Fallon, Marie; Power, Derek G.; Wilcock, Andrew; Maddocks, Matthew; Bennett, Mike; Usborne, Caroline; Laird, Barry; McMillan, Donald C.

doi:10.3390/cancers12051187

Cited by 40 publications

(30 citation statements)

References 46 publications

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“…Furthermore, in those patients, 42% had an elevated mGPS. One interpretation of the findings is that obvious weight loss in patients with advanced cancer is a later event than functional decline, and that functional decline is a later event than the development of a systemic inflammatory response [14]. Therefore, it may be that the mGPS should form the basis of stratification of likely survival in patients with advanced cancer.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the prognostic value of ECOG-PS, mGPS and BMI/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer

et al. 2020

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Background and Aims:The systemic inflammatory response is associated with the loss of lean tissue, anorexia, weakness, fatigue and reduced survival in patients with advanced cancer and therefore is important in the definition of cancer cachexia. The aim of the present study was to carry out a direct comparison of the prognostic value of Eastern Cooperative Oncology Group Performance Status (ECOG-PS), modified Glasgow Prognostic Score (mGPS) and Body Mass Index/Weight Loss Grade (BMI/WL grade) in patients with advanced cancer.Method: All data were collected prospectively across 18 sites in the UK and Ireland.Patient's age, sex, ECOG-PS, mGPS and BMI/WL grade were recorded, as were details of underlying disease including metastases. Survival data were analysed using univariate and multivariate Cox regression.Results: A total of 730 patients were assessed. The majority of patients were male (53%), over 65 years of age (56%), had an ECOG-PS>0/1 (56%), mGPS≥1 (56%), BMI≥25 (51%), <2.5% weight loss (57%) and had metastatic disease (86%). On multivariate cox regression analysis ECOG-PS (HR 1.61 95%CI 1.42-1.83, p<0.001), mGPS (HR 1.53, 95%CI 1.39-1.69, p<0.001) and BMI/WL grade (HR 1.41, 95%CI 1.25-1.60, p<0.001) remained independently associated with overall survival. In patients with a BMI/WL grade 0/1 both ECOG and mGPS remained independently associated with overall survival. Conclusion:The ECOG/mGPS framework may form the basis of risk stratification of survival in patients with advanced cancer.

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Section: Discussionmentioning

confidence: 99%

Comparison of the prognostic value of ECOG-PS, mGPS and BMI/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer

et al. 2020

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“…However, in a recent publication, the relationship between the mGPS and measures of physical activity was examined in patients with advanced lung cancer. 18 This study showed that an elevated mGPS was significantly and independently associated with poorer handgrip strength. Therefore, there is some evidence that the presence of the systemic inflammatory response is associated with a poor capacity for activity in patients with cancer.…”

Section: Discussionmentioning

confidence: 65%

“…In the present study of patients with operable CRC, there was no direct measure of physical function made and so we were unable to explore the relationship between the systemic inflammatory response and physical activity in these patients. However, in a recent publication, the relationship between the mGPS and measures of physical activity was examined in patients with advanced lung cancer 18 . This study showed that an elevated mGPS was significantly and independently associated with poorer handgrip strength.…”

Section: Discussionmentioning

confidence: 99%

The relationship between systemic inflammation, body composition and clinical outcomes in patients with operable colorectal cancer at low and medium to high nutritional risk

Abbass

Dolan

Horgan

et al. 2020

JCSM Clinical Reports

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BackgroundIn accordance with European Society of Parenteral and Enteral Nutrition guidelines, the combination of malnutrition universal screening tool (MUST), systemic inflammation [modified Glasgow prognostic score (mGPS)] and body composition [skeletal muscle index (SMI) and skeletal muscle density (SMD)] were examined in relation to clinical outcomes in patients undergoing surgery for colorectal cancer (CRC).MethodsData were collected for stages I–III CRC patients from prospectively maintained data base at the academic department of surgery, Glasgow Royal Infirmary. From the initial sample of 1046, pre‐admission MUST score was available in 984 patients. The classification into low malnutrition risk (MUST = 0, n = 810) and moderate to high malnutrition risk (MUST 1 to ≥2, n = 174) groups and their relationship to systemic inflammatory response and body composition (SMI and SMD) with clinical outcomes were examined using univariate and multivariate analyses.ResultsCompared with those patients at low nutrition risk (MUST = 0), patients at moderate to high malnutrition risk (MUST 1 to ≥2) had an elevated mGPS (P < 0.001), neutrophil lymphocyte ratio (NLR) (P < 0.001), low SMI (P ≤ 0.001) and low SMD (P = 0.015). MUST was an important prognostic factor for length of hospital stay (P < 0.001) and 3 years overall survival (P < 0.001).In low malnutrition risk patients (MUST = 0), those who were systemically inflammed (mGPS 1/2, n = 187), had an elevated NLR (P < 0.001), low SMI (P < 0.001), low SMD (P < 0.01), increased post‐operative complications (P < 0.05), longer hospital stay >7 days (P < 0.001), and poorer 3 years survival (P < 0.05) compared with those who were not systemically inflamed. On multivariate analysis, American Society of Anaesthesiologist (ASA) score (P < 0.05) and mGPS (P < 0.05) were independently associated with increased risk of clinical complications. ASA, mGPS, and NLR were independently associated with prolonged hospital stay (P < 0.05, P < 0.05, and P < 0.001, respectively). ASA, tumour, node, metastasis stage, and mGPS were independently associated with overall survival (P < 0.01, P < 0.001, and P < 0.05, respectively).In medium‐risk to high‐risk patients (MUST = 1/2), those who were systemically inflamed (mGPS 1/2, n = 75) had higher ASA (P < 0.05), elevated NLR (P < 0.01), low SMI (P = 0.05) and low SMD (P < 0.05), increased length of hospital stay (P < 0.05), and poorer 3 years survival (P < 0.01), compared with those who were not systemically inflamed.ConlusionsA small proportion of patients with primary operable CRC was at nutrition risk as defined by MUST alone in both low risk nutrition patients and medium/high risk nutrition patients. The systemic inflammatory response was associated with lower SMI, lower SMD, and poor clinical outcomes. The systemic inflammatory response is an important measure in the nutritional assessment of patients undergoing surgery for CRC.

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“…Body mass index has been found associated with CRC postoperative complications and survival outcomes. However, traditional indexes, such as Mets, BMI, waist/hip ratio, and ECOG-PS, do not provide detailed quantitative data for clinical reference [ 15 ]. Recently, body composition has appeared as a substitution to the traditional index.…”

Section: Discussionmentioning

confidence: 99%

Association between CT‐Quantified Body Composition and Recurrence, Survival in Nonmetastasis Colorectal Cancer Patients Underwent Regular Chemotherapy after Surgery

Ying

Jin

et al. 2021

BioMed Research International

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Background. Body mass index, measured at colorectal cancer (CRC) diagnosis has been associated with recurrence and survival outcomes. Computed tomography- (CT-) defined body compositions accurately reflect body mass, but there was no consistent perspective on the influence of visceral adipose tissue (VAT) and skeletal muscle mass (SM) on the prognosis of nonmetastasis CRC, especially in the patients underwent surgery and regularly standard chemotherapy. Methods. We investigated the associations of CT-quantified body composition (VAT and SM) with CRC patients successively underwent surgery and regular 8-12 of periods standard chemotherapy. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body compositions was analyzed using the Cox regression model, and precise clinical nomograms were established. Results. In XELOX-treated patients, progression-free survival (PFS) ( P = 0.025 ) and overall survival (OS) ( P = 0.032 ) were lower in the high-SM than in the low-SM group. The univariate analysis demonstrated that compared with low-SM patients, patients with high-SM showed a strikingly poor prognosis in both OS ( P = 0.0512 ) and PFS in the T4 subgroup ( P = 0.0417 ), while contrary to the T2-3 subgroup. Conclusions. CT-quantified body compositions have a significant influence on CRC patients successively underwent curative resection and regularly standard chemotherapy with the endpoints of 1-year, 3-year, and 5-year both OS and PFS. Patients with high-SM showed a strikingly poor prognosis in OS and PFS in the T4 subgroup; however, the prognosis role of body composition was opposite in T2-3 patients.

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The Relationship between ECOG-PS, mGPS, BMI/WL Grade and Body Composition and Physical Function in Patients with Advanced Cancer

Cited by 40 publications

References 46 publications

Comparison of the prognostic value of ECOG-PS, mGPS and BMI/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer

Comparison of the prognostic value of ECOG-PS, mGPS and BMI/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer

The relationship between systemic inflammation, body composition and clinical outcomes in patients with operable colorectal cancer at low and medium to high nutritional risk

Association between CT‐Quantified Body Composition and Recurrence, Survival in Nonmetastasis Colorectal Cancer Patients Underwent Regular Chemotherapy after Surgery

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