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Comprehensive comparison of the prognostic value of systemic inflammation biomarkers for cancer cachexia: a multicenter prospective study

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Abstract

Aims

Systemic inflammation plays an important role in cancer cachexia. However, among the systemic inflammatory biomarkers, it is unclear which has optimal prognostic value for cancer cachexia.

Methods

The Kaplan–Meier method was used and the log-rank analysis was performed to estimate survival differences between groups. Cox proportional hazard regression analyses were conducted to assess independent risk factors for all-cause mortality.

Results

The C-reactive protein-to-albumin ratio (CAR) was the optimal prognostic assessment tool for patients with cancer cachexia, with 1-, 3-, and 5-year predictive powers of 0.650, 0.658, and 0.605, respectively. Patients with a high CAR had significantly lower survival rates than those with a low CAR. Moreover, CAR can differentiate the prognoses of patients with the same pathological stage. Cox proportional risk regression analyses showed that a high CAR was an independent risk factor for cancer cachexia. For every standard deviation increase in CAR, the risk of poor prognosis for patients with cancer cachexia was increased by 20% (hazard ratio = 1.200, 95% confidence interval = 1.132–1.273, P < 0.001).

Conclusions

CAR is an effective representative of systemic inflammation and a powerful factor for predicting the life function and clinical outcome of patients with cancer cachexia.

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Acknowledgements

We thank all the patients and their families for participating in the study. This study was supported by the National Key Research and Development Program to Dr. Han** Shi (No. 2017YFC1309200, No. 2022YFC2009600) and the Bei**g Municipal Science and Technology Commission (SCW2018-06).

Author information

Author notes

  1. Hailun ** Shi

  2. Bei**g International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Bei**g, 100038, China

    Hailun ** Shi

  3. Key Laboratory of Cancer FSMP for State Market Regulation, Bei**g, 100038, China

    Hailun ** Shi

  4. Department of Geriatric Respiratory Disease Ward, The First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China

    Lishuang Wei

  5. Department of Epidemiology, College of Public Health, Zhengzhou University, Zhenzhou, 450000, China

    Chun-Hua Song

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  1. Hailun **e
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Contributions

HPS, HLX, GTR and LSW designed the study; HYZ, YZG and QZ conducted the literature search; YZG, QZ, MY, MT, and SQL collected the data; MMS, XZ, CHS, LD, and XYL analyzed the data; HLX, GTR and LSW wrote the article; HPS revised the article and took the decision to submit the article for publication. All authors read and approved the final manuscript.

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Correspondence to Han** Shi.

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**e, H., Ruan, G., Wei, L. et al. Comprehensive comparison of the prognostic value of systemic inflammation biomarkers for cancer cachexia: a multicenter prospective study. Inflamm. Res. 71, 1305–1313 (2022). https://doi.org/10.1007/s00011-022-01626-7

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