Prognostic value of the Global Leadership Initiative on Malnutrition criteria including systemic inflammation in patients with advanced cancer

TY - JOUR

T1 - Prognostic value of the Global Leadership Initiative on Malnutrition criteria including systemic inflammation in patients with advanced cancer

AU - Rocha, Bruna M M

AU - McGovern, Josh

AU - Paiva, Carlos E

AU - Dolan, Ross D

AU - Paiva, Bianca S R

AU - Preto, Daniel D

AU - Laird, Barry J

AU - Maia, Yara C P

AU - McMillan, Donald C

N1 - Publisher Copyright: © The Author(s), 2025.

PY - 2025/1/28

Y1 - 2025/1/28

N2 - An assessment of systemic inflammation and nutritional status may form the basis of a framework to examine the prognostic value of cachexia in patients with advanced cancer. The objective of the study was to examine the prognostic value of the Global Leadership Initiative on Malnutrition criteria, including BMI, weight loss (WL) and systemic inflammation (as measured by the modified Glasgow Prognostic Score (mGPS)), in advanced cancer patients. Three criteria were examined in a combined cohort of patients with advanced cancer, and their relationship with survival was examined using Cox regression methods. Data were available on 1303 patients. Considering BMI and the mGPS, the 3-month survival rate varied from 74 % (BMI > 28 kg/m 2) to 61 % (BMI < 20 kg/m 2) and from 84 % (mGPS 0) to 60 % (mGPS 2). Considering WL and the mGPS, the 3-month survival rate varied from 81 % (WL ± 2·4 %) to 47 % (WL ≥ 15 %) and from 93 % (mGPS 0) to 60 % (mGPS 2). Considering BMI/WL grade and mGPS, the 3-month survival rate varied from 86 % (BMI/WL grade 0) to 59 % (BMI/WL grade 4) and from 93 % (mGPS 0) to 63 % (mGPS 2). When these criteria were combined, they better predicted survival. On multivariate survival analysis, the most highly predictive factors were BMI/WL grade 3 (HR 1·454, P = 0·004), BMI/WL grade 4 (HR 2·285, P < 0·001) and mGPS 1 and 2 (HR 1·889, HR 2·545, all P < 0·001). In summary, a high BMI/WL grade and a high mGPS as outlined in the BMI/WL grade/mGPS framework were consistently associated with poorer survival of patients with advanced cancer. It can be readily incorporated into the routine assessment of patients.

AB - An assessment of systemic inflammation and nutritional status may form the basis of a framework to examine the prognostic value of cachexia in patients with advanced cancer. The objective of the study was to examine the prognostic value of the Global Leadership Initiative on Malnutrition criteria, including BMI, weight loss (WL) and systemic inflammation (as measured by the modified Glasgow Prognostic Score (mGPS)), in advanced cancer patients. Three criteria were examined in a combined cohort of patients with advanced cancer, and their relationship with survival was examined using Cox regression methods. Data were available on 1303 patients. Considering BMI and the mGPS, the 3-month survival rate varied from 74 % (BMI > 28 kg/m 2) to 61 % (BMI < 20 kg/m 2) and from 84 % (mGPS 0) to 60 % (mGPS 2). Considering WL and the mGPS, the 3-month survival rate varied from 81 % (WL ± 2·4 %) to 47 % (WL ≥ 15 %) and from 93 % (mGPS 0) to 60 % (mGPS 2). Considering BMI/WL grade and mGPS, the 3-month survival rate varied from 86 % (BMI/WL grade 0) to 59 % (BMI/WL grade 4) and from 93 % (mGPS 0) to 63 % (mGPS 2). When these criteria were combined, they better predicted survival. On multivariate survival analysis, the most highly predictive factors were BMI/WL grade 3 (HR 1·454, P = 0·004), BMI/WL grade 4 (HR 2·285, P < 0·001) and mGPS 1 and 2 (HR 1·889, HR 2·545, all P < 0·001). In summary, a high BMI/WL grade and a high mGPS as outlined in the BMI/WL grade/mGPS framework were consistently associated with poorer survival of patients with advanced cancer. It can be readily incorporated into the routine assessment of patients.

KW - Humans

KW - Neoplasms/complications

KW - Male

KW - Female

KW - Malnutrition/diagnosis

KW - Inflammation/diagnosis

KW - Body Mass Index

KW - Middle Aged

KW - Prognosis

KW - Aged

KW - Cachexia/diagnosis

KW - Nutritional Status

KW - Weight Loss

KW - Nutrition Assessment

KW - Leadership

KW - Proportional Hazards Models

KW - Aged, 80 and over

KW - Systemic inflammatory response

KW - Cachexia

KW - Body composition

KW - Advanced cancer

KW - Malnutrition

UR - https://www.scopus.com/pages/publications/85214557952

U2 - 10.1017/S0007114524003271

DO - 10.1017/S0007114524003271

M3 - Article

C2 - 39773545

SN - 0007-1145

VL - 133

SP - 246

EP - 252

JO - British Journal of Nutrition

JF - British Journal of Nutrition

IS - 2

ER -