ESPEN 2022 Abstract Submission
Topic: Nutrition and cancer
Abstract Submission Identifier: ESPEN22-ABS-1084
COMPREHENSIVE COMPARISON OF THE PROGNOSTIC VALUE OF SYSTEMIC INFLAMMATORY MARKERS FOR CANCER CACHEXIA: A MULTICENTER PROSPECTIVE STUDY
H. Xie*, 1, H. Shi 1
1Department of Gastrointestinal Surgery, BEIJING SHIJITAN HOSPITAL, CAPITAL MEDICAL UNIVERSITY, Beijing, China
Rationale: Systemic inflammation plays an important role in cancer cachexia. However, among the known systemic inflammatory biomarkers, it is unclear which has optimal prognostic value for cancer cachexia. Therefore, this study aimed to systematically and comprehensively compare a combination of various inflammation parameters to identify the optimal systemic inflammation markers for assessing the prognosis of cancer cachexia populations.
Methods: Based on the pairwise combination of upregulated and downregulated serum inflammation parameters, we identified six systemic inflammation biomarkers. A time-dependent receiver operator characteristic curve was calculated to compare the predictive capacities of these biomarkers. The Kaplan-Meier method and log-rank analysis were used to estimate survival differences between groups. Cox proportional hazard regression analyses were used to assess independent risk factors for all-cause mortality. Logistic regression models were used to assess the association of the markers with patients’ daily functions and short-term outcomes.
Results: Among these systemic inflammation markers, the C-reactive protein-to-albumin ratio (CAR) was the optimal prognostic assessment tool for patients with cancer cachexia, with 1-, 3-, and 5-year predictive powers of 0.650, 0.658, and 0.605, respectively. Patients with a high CAR had significantly lower survival rates than those with a low CAR (42.8% vs. 63.7%, P < 0.001). Moreover, CAR can differentiate the prognoses of patients with the same pathological stage. Cox proportional risk regression analyses showed that a high CAR was an independent risk factor for cancer cachexia. For every standard deviation increase in CAR, the risk of poor prognosis for patients with cancer cachexia increased by 20% (hazard ratio = 1.200, 95% confidence interval = 1.132 – 1.273, P < 0.001). Logistic regression models showed that a high CAR is a high-risk factor for adverse daily functions and short-term outcomes in patients with cancer cachexia. Randomized internal validation confirmed that CAR has good application prospects for predicting the prognosis of patients with cancer cachexia.
Conclusion: This study confirmed that CAR, as an effective representative of systemic inflammation, is a powerful factor in predicting the life function and clinical outcome of patients with cancer cachexia, which will help to guide the formulation of early anti-inflammatory treatment strategies and monitoring of efficacy.
Disclosure of Interest: None Declared
Keywords: biomarker, cachexia, cancer, systemic inflammation