The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study

Tan, Cindy; Read, Jane; Phan, Viet Hong; Beale, Philip; Peat, Jennifer K.; Clarke, Stephen

doi:10.1007/s00520-014-2385-y

Cited by 91 publications

(64 citation statements)

References 39 publications

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“…In our study, several inflammatory markers were altered, especially in patients with high weight loss and malnourished, demonstrating that, as marker values were inadequate, inflammation was worse and %WL was higher. Lima et al 16 and Costa et al 19 , and the association between these markers and nutritional status has been previously assessed 14,22 . A recent Asian study of 64 patients with esophageal cancer found a strong association between nutritional status by PG-SGA and performance scores.…”

Section: Resultsmentioning

confidence: 99%

“…Recently, studies have demonstrated an important association between nutritional depletion and inflammation in cancer patients [4][5][6]14,16,17,[19][20][21][22] , including GIT tumors. Since cancer patients are in a constant state of inflammation, and considering the role of this systemic inflammation in progressive weight loss and muscle mass, cancer cachexia can be identified by the presence and alteration of certain inflammatory markers [5][6][7] .…”

Section: Resultsmentioning

confidence: 99%

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Inflammatory and nutritional statuses of patients submitted to resection of gastrointestinal tumors

Fruchtenicht

Poziomyck

Reis

et al. 2018

Rev. Col. Bras. Cir.

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Objective: to evaluate the association between the nutritional and the inflammatory statuses of patients with cancer of the gastrointestinal tract undergoing surgical resection and to identify predictors of mortality in these patients. Methods: we conducted a prospective study of 41 patients with gastrointestinal tract cancer submitted to surgery between October 2012 and December 2014. We evaluated the nutritional status by subjective and objective methods. We assessed the inflammatory response and prognosis using the modified Glasgow Prognostic Score (mGPS), Neutrophil/Lymphocyte Ratio (NLR), Onodera Prognostic Nutritional Index (mPNI), Inflammatory-Nutritional Index (INI) and C-Reactive Protein/Albumin ratio (mPINI). Results: half of the patients were malnourished and 27% were at nutritional risk. There was a positive association between the percentage of weight loss (%WL) and the markers NLR (p=0.047), mPINI (p=0.014) and INI (p=0.015). Serum albumin levels (p=0.015), INI (p=0.026) and mPINI (p=0.026) were significantly associated with the PG-SGA categories. On multivariate analysis, albumin was the only inflammatory marker independently related to death (p=0.004). Conclusion: inflammatory markers were significantly associated with malnutrition, demonstrating that the higher the inflammatory response, the worse the PG-SGA (B and C) scores and the higher the %WL in these patients. However, further studies aimed at improving surgical outcomes and determining the role of these markers as predictors of mortality are required.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Inflammatory and nutritional statuses of patients submitted to resection of gastrointestinal tumors

Fruchtenicht

Poziomyck

Reis

et al. 2018

Rev. Col. Bras. Cir.

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“…Several studies have demonstrated that weight loss and a low serum albumin level are closely associated with systemic inflammation in cancer patients [42,43], and NLR has also been reported to predict poor outcome in patients with different cancer types like colorectal cancer or hepatocellular carcinoma [44,45]. As a result, the ALI was initially developed, using these markers, to provide a unified index for assessing ongoing systemic inflammation in patients with metastatic lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of the Pretreatment Advanced Lung Cancer Inflammation Index (ALI) in Diffuse Large B Cell Lymphoma Patients Treated with R-CHOP Chemotherapy

Park

Lee

et al. 2017

Acta Haematol

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Background: The Advanced Lung Cancer Inflammation Index (ALI, body mass index × albumin/neutrophil-to-lymphocyte ratio) has been demonstrated to be a prognostic factor of survival in some solid cancers. We retrospectively investigated the usefulness of the ALI to predict chemotherapy response and survival in 212 patients with diffuse large B cell lymphoma (DLBCL) treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy. Methods: Patients were allocated to a low ALI group (n = 82, 38.7%) or a high ALI group (n = 130, 61.3%) according to an optimal pretreatment ALI cut-off value of 15.5 as determined by receiver operating curve analysis. Results: The low ALI group displayed more adverse clinical characteristics, lower rates of complete remission (54.9 vs. 75.4%, p = 0.008), and poorer 5-year progression-free (PFS, 58.1 vs. 77.3%, p = 0.006) and overall (OS, 64.2 vs. 80.2%, p = 0.008) survival. Multivariate analysis showed that low ALI was found to independently predict shorter PFS and OS. Interestingly, a low ALI reverted to a high ALI during treatment in 58 patients (27.4%), and the 5-year OS of these patients was better than that of patients whose ALI remained low (n = 24, 72.5 vs. 24%, p < 0.001). Conclusions: ALI might be an easily available marker for predicting clinical outcomes in DLBCL patients treated with R-CHOP chemotherapy.

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“…Markers of nutritional status have been predictive of outcomes in gastrointestinal cancers (6)(7)(8). Specifically, body mass index (BMI) has been widely evaluated due to its ability to normalize for patient height (9)(10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%

Impact of sarcopenia in borderline resectable and locally advanced pancreatic cancer patients receiving stereotactic body radiation therapy

Jin¹,

Mellon²,

Frakes³

et al. 2018

J. Gastrointest. Oncol.

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Background: Total psoas area (TPA), a marker of sarcopenia, has been used as an independent predictor of clinical outcomes in gastrointestinal (GI) cancers as a proxy for frailty and nutritional status. Our study aimed to evaluate whether TPA, in contrast to traditional measurements of nutrition like body mass index (BMI) and body surface area (BSA), was predictive of outcomes in borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC) patients receiving stereotactic body radiation therapy (SBRT). Methods: Retrospective analysis of an institutional review board approved database of 222 BRPC and LAPC treated with SBRT from 2009-2016 yielded 183 patients that met our selection criteria of pre-SBRT computed tomography (CT) imaging with an identifiable L4 vertebra. Once the L4 vertebral level was identified, the bilateral psoas muscles were manually contoured. This area was normalized by patient height, with units described in mm 2 /m 2 . Receiver operating characteristic (ROC) curves were generated for TPA, BMI, and BSA to elicit clinically relevant cutoffs. Regression and Kaplan-Meier analyses were used to correlate toxicity with survival functions.Results: Low TPA (OR =1.903, P=0.036) was predictive of acute toxicities, and only TPA was predictive of Grade 3 or higher acute toxicities (OR =10.24, P=0.007). Both findings were independent of tumor resectability. Pain (P=0.003), fatigue (P=0.040), and nausea (P=0.039) were significantly associated with low TPA. No association was identified between any measurement of nutritional status and the development of late toxicities, overall survival, local progression or local recurrence. However, BRPC patients survived longer (median =21.98 months) than their LAPC (median =16.2 months) counterparts (P=0.002), independent of nutritional status. Conclusions: TPA measurement is readily available and more specific than BMI or BSA as a predictor of acute radiotoxic complications following SBRT in BRPC/LAPC patients. A TPA of <500 mm 2 /m 2 is a clinically relevant cutoff that can direct physicians to address expected complications of pain, fatigue, and nausea. However, tumor resectability remains as the only predictor of overall survival in this cohort.

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The relationship between nutritional status, inflammatory markers and survival in patients with advanced cancer: a prospective cohort study

Abstract: Inflammatory markers were statistically associated with malnutrition. Malnutrition and mGPS were significant independent predictors of overall survival in patients with advanced cancer.

Cited by 91 publications

References 39 publications

Inflammatory and nutritional statuses of patients submitted to resection of gastrointestinal tumors

Inflammatory and nutritional statuses of patients submitted to resection of gastrointestinal tumors

Prognostic Value of the Pretreatment Advanced Lung Cancer Inflammation Index (ALI) in Diffuse Large B Cell Lymphoma Patients Treated with R-CHOP Chemotherapy

Impact of sarcopenia in borderline resectable and locally advanced pancreatic cancer patients receiving stereotactic body radiation therapy

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