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. 2022 Sep 23:12:984459.
doi: 10.3389/fonc.2022.984459. eCollection 2022.

Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study

Qianyi Wan  1 , Qian Yuan  2 , Rui Zhao  1 , Xiaoding Shen  1 , Yi Chen  1 , Tao Li  3 , Yinghan Song  4
Affiliations

Prognostic value of cachexia index in patients with colorectal cancer: A retrospective study

Qianyi Wan et al. Front Oncol. .

Abstract

Background: Current diagnostic criteria for cancer cachexia are inconsistent, and arguments still exist about the impact of cachexia on the survival of patients with colorectal cancer. In this study, we aim to investigate the prognostic value of a novel cachexia indicator, the cachexia index (CXI), in patients with colorectal cancer.

Methods: The CXI was calculated as skeletal muscle index (SMI) × serum albumin/neutrophil-lymphocyte ratio. The cut-off value of CXI was determined by the receiver operating characteristic (ROC) curves and Youden's index. The major outcomes were major complications, overall survival (OS), and recurrence-free survival (RFS).

Results: A total of 379 patients (234 men and 145 women) were included. The ROC curves indicated that CXI had a significantly diagnostic capacity for the detection of major complications. Based on Youden's index, there were 231 and 148 patients in the low and high CXI groups, respectively. Patients in the low CXI group had significantly older age, lower BMI, and a higher percentage of cachexia and TNM stage II+III. Besides, Patients in low CXI group were associated with a significantly higher rate of major complications, blood transfusion, and longer length of stay. Logistic regression analysis indicated that low CXI, cachexia, and coronary heart disease were independent risk factors for the major complications. Kaplan Meier survival curves indicated that patients with high CXI had a significantly more favorable OS than those with low CXI, while no significant difference was found in RFS between the two groups. Besides, there were no significant differences in OS or RFS between patients with and without cachexia. The univariate and multivariate Cox regression analysis indicated that older age, low CXI, and coronary heart disease instead of cachexia were associated with a decreased OS.

Conclusion: CXI was better than cachexia in predicting OS and could be a useful prognostic indicator in patients with colorectal cancer, and greater attention should be paid to patients with low CXI.

Keywords: cachexia index; cancer cachexia; colorectal cancer; major complications; overall survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Representative CT image of the skeletal muscle area at L3 level: (Green) skeletal muscle; (Blue) visceral adipose tissue; (Red) subcutaneous adipose tissue.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curves of cachexia index (CXI) for the detection of major complications.
Figure 3
Figure 3
Kaplan Meier survival curves for the associations between cachexia index (CXI) and (A) overall survival; (B) recurrence free survival.
Figure 4
Figure 4
Kaplan Meier survival curves for the associations between cachexia and (A) overall survival; (B) recurrence free survival.
See this image and copyright information in PMC

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