Integrated neutrophil-to-lymphocyte ratio and handgrip strength better predict survival in patients with cancer cachexia

• Published in: Nutrition (Burbank, Los Angeles County, Calif.) Vol. 122; p. 112399
• Main Authors: Zhang, Kai-Lun, Zhou, Ming-Ming, Wang, Kun-Hua, Weng, Min, Zhou, Fu-Xiang, Cui, Jiu-Wei, Li, Wei, Ma, Hu, Guo, Zeng-Qing, Li, Su-Yi, Chen, Jun-Qiang, Wu, Xiang-Hua, Zhao, Qing-Chuan, Li, Ji-Peng, Xu, Hong-Xia, Shi, Han-Ping, Song, Chun-Hua
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2024; Elsevier Limited
• Subjects: Blood; Body mass index; Cachexia; Cachexia - etiology; Cancer; Cancer cachexia; Clinical outcomes; Cohort Studies; confidence interval; Confidence intervals; death; Evaluation; Female; Females; Hand Strength; Handgrip strength; hazard ratio; Humans; Inflammation; Leukocytes (neutrophilic); Lymphocytes; Male; Males; Malnutrition; Medical prognosis; mortality; Muscle strength; Musculoskeletal system; Neoplasms - complications; Neutrophil-to-lymphocyte ratio; Neutrophils; Nutrition; Patients; Physiology; Prognosis; Prognostic; Quality of life; Questionnaires; Regression analysis; Regression models; Retrospective Studies; risk; Serology; Skeletal muscle; Statistical analysis; Survival; Tumors; China; Cancer cachexia; Handgrip strength; Malnutrition; Neutrophil-to-lymphocyte ratio; Prognostic
• DOI: 10.1016/j.nut.2024.112399
• ISSN: 0899-9007; 1873-1244

•The NH index combined with NLR and HGS is an effective predictor of the prognosis of patients with cancer cachexia.•The study was conducted on a multicenter observational cohort with a large sample, which enhances the credibility, reliability, and representativeness of our results.•The study can offer patients with cancer cachexia effective prognosis stratification and guidance for clinical care. Systemic inflammation and skeletal muscle strength play crucial roles in the development and progression of cancer cachexia. In this study we aimed to evaluate the combined prognostic value of neutrophil-to-lymphocyte ratio (NLR) and handgrip strength (HGS) for survival in patients with cancer cachexia. This multicenter cohort study involved 1826 patients with cancer cachexia. The NLR-HGS (NH) index was defined as the ratio of neutrophil-to-lymphocyte ratio to handgrip strength. Harrell's C index and receiver operating characteristic (ROC) curve analysis were used to assess the prognosis of NH. Kaplan–Meier analysis and Cox regression models were used to evaluate the association of NH with all-cause mortality. Based on the optimal stratification, 380 women (NH > 0.14) and 249 men (NH > 0.19) were classified as having high NH. NH has shown greater predictive value compared to other indicators in predicting the survival of patients with cancer cachexia according to the 1-, 3-, and 5-y ROC analysis and Harrell's C index calculation. Multivariate survival analysis showed that higher NH was independently associated with an increased risk of death (hazard ratio = 1.654, 95% confidence interval = 1.389–1.969). This study demonstrates that the NH index, in combination with NLR and HGS, is an effective predictor of the prognosis of patients with cancer cachexia. It can offer effective prognosis stratification and guidance for their treatment.