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Accepted manuscript

Prognostic value of GLIM criteria including systemic inflammation in patients with advanced cancer

Published online by Cambridge University Press:  08 January 2025

Bruna M M Rocha
Affiliation:
Molecular Biology and Nutrition and Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, 38405-320, Minas Gerais, Brazil. brunammalagoli@gmail.com, yara.maia@ufu.br
Josh McGovern
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, United Kingdom. Josh.McGovern@glasgow.ac.uk, Ross.Dolan@glasgow.ac.uk, Donald.McMillan@glasgow.ac.uk
Carlos E Paiva
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, 14784-400, Sao Paulo, Brazil. caredupai@gmail.com, bsrpaiva@gmail.com, ddpreto@gmail.com
Ross D Dolan
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, United Kingdom. Josh.McGovern@glasgow.ac.uk, Ross.Dolan@glasgow.ac.uk, Donald.McMillan@glasgow.ac.uk
Bianca S R Paiva
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, 14784-400, Sao Paulo, Brazil. caredupai@gmail.com, bsrpaiva@gmail.com, ddpreto@gmail.com
Daniel D Preto
Affiliation:
Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, 14784-400, Sao Paulo, Brazil. caredupai@gmail.com, bsrpaiva@gmail.com, ddpreto@gmail.com
Barry J Laird
Affiliation:
Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, EH4 2XU, Scotland, United Kingdom. barry.laird@ed.ac.uk
Yara C P Maia*
Affiliation:
Molecular Biology and Nutrition and Research Group, School of Medicine, Federal University of Uberlandia, Uberlandia, 38405-320, Minas Gerais, Brazil. brunammalagoli@gmail.com, yara.maia@ufu.br
Donald C McMillan
Affiliation:
Academic Unit of Surgery, School of Medicine, University of Glasgow, New Lister Building, Royal Infirmary, Glasgow, G31 2ER, Scotland, United Kingdom. Josh.McGovern@glasgow.ac.uk, Ross.Dolan@glasgow.ac.uk, Donald.McMillan@glasgow.ac.uk
*
Corresponding author: Yara Cristina de Paiva Maia Nutrition and Molecular Biology Research Group Federal University of Uberlandia, School of Medicine, Federal University of Uberlandia, Uberlandia, Minas Gerais, Brazil, 38405-320 E-mail: yara.maia@ufu.br
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Abstract

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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 GLIM criteria, including body mass index (BMI), weight loss (WL) and systemic inflammation (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.

Type
Full Papers
Copyright
The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society