Nutrition-inflammation marker enhances prognostic value to ECOG performance status in overweight or obese patients with cancer

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 47; no. 1; p. 109
• Main Authors: Zhang, Xi, Zhang, Qi, Tang, Meng, Zhang, Kang-Ping, Zhang, Xiao-Wei, Song, Meng-Meng, Ruan, Guo-Tian, Sun, Qiang, Li, Wei, Xu, Hong-Xia, Cong, Ming-Hua, Deng, Li, Shi, Han-Ping
• Format: Journal Article
• Language: English
• Published: United States 01.01.2023
• Subjects: Gastrointestinal Neoplasms; Humans; Inflammation; Obesity - complications; Overweight - complications; Prognosis; overweight or obese; LCR; nutrition-inflammation marker; prognosis; cancer patients
• ISSN: 1941-2444
• DOI: 10.1002/jpen.2407

Overweight or obese cancer patients are more likely to develop a proinflammatory status. The aim of this study was to investigate whether the nutrition-inflammation marker can provide additional prognostic information on top of well-established Eastern Cooperative Oncology Group performance status (ECOG-PS) in overweight or obese patients with cancer. A total of 1667 overweight or obese cancer patients were enrolled in this study. We assessed the prediction accuracy of 10 nutrition-inflammation markers by time-dependent receiver operating characteristic (ROC) and elucidated their association with overall survival by the Kaplan-Meier method and a Cox model. In this analysis, the majority of patients had a good performance status (ECOG-PS score ≤1; 88.3%). Both the area under ROC curves and the C-index of the lymphocyte-C-reactive protein ratio (LCR) demonstrated that LCR was the most significant nutrition-inflammation marker correlated with survival. In patients with good ECOG-PS, a low LCR was significantly associated with poorer prognosisand enhanced the predictive ability of one-year mortality. For specific tumor types, a low LCR was an independent prognostic factor for lung cancer, upper gastrointestinal cancer, and colorectal cancer, and it tended to be a significant predictor for breast cancer. In addition, those patients with a combined low LCR and poorer ECOG-PS (ECOG-PS score >1) showed the worst prognosis. The LCR is more strongly associated with overall survival than other nutrition-inflammation markers, and it is able to further detect patients with worse prognosis on top of ECOG-PS in overweight or obese patients with cancer.