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

Published online by Cambridge University Press:  08 January 2025

Bruna M. M. Rocha ,
Josh McGovern ,
Carlos E. Paiva ,
Ross D. Dolan ,
Bianca S. R. Paiva ,
Daniel D. Preto ,
Barry J. Laird ,
Yara C. P. Maia Open the ORCID record for Yara C. P. Maia [Opens in a new window]  and
Donald C. McMillan
Bruna M. M. Rocha
Affiliation:
Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Minas Gerais, Brazil
Josh McGovern
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow G31 2ER, Scotland, UK
Carlos E. Paiva
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil
Ross D. Dolan
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow G31 2ER, Scotland, UK
Bianca S. R. Paiva
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil
Daniel D. Preto
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil
Barry J. Laird
Affiliation:
Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH4 2XU, Scotland, UK
Yara C. P. Maia*
Affiliation:
Molecular Biology and Nutrition Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia 38405-320, Minas Gerais, Brazil
Donald C. McMillan
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow G31 2ER, Scotland, UK
*
Corresponding author: Yara Cristina de Paiva Maia; Email: yara.maia@ufu.br
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Abstract

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/m2) to 61 % (BMI < 20 kg/m2) 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.

Keywords

Advanced cancerSystemic inflammatory responseBody compositionMalnutritionCachexiaPrognosis
Type
Research Article
Information
British Journal of Nutrition , First View , pp. 1 - 7
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

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