Association of Systemic Inflammation and Overall Survival in Elderly Patients with Cancer Cachexia – Results from a Multicenter Study

作者：Guo‐Tian Ruan, Ming Yang, Xiaowei Zhang, Mengmeng Song, Chunlei Hu, Yi‐Zhong Ge, Hailun Xie, Tong Liu, Meng Tang, Qi Zhang, Xi Zhang, Kang‐Ping Zhang, Xiangrui Li, Qin‐Qin Li, Yongbing Chen, Kaiying Yu, Minghua Cong, Kunhua Wang, Hanping Shi · 发表于：Journal of Inflammation Research · 年份：2021 · DOI：10.2147/jir.s332408 · 被引用次数：44 · 研究领域：Nutrition and Health in Aging、Inflammatory Biomarkers in Disease Prognosis、Frailty in Older Adults

Background: Systemic inflammation and cachexia are associated with adverse clinical outcomes in elderly patients with cancer. The survival outcomes of elderly patients with cancer cachexia (EPCC) with high inflammation and a high risk of mortality are unknown. This study aimed to investigate the impact of high inflammation on the prognosis of EPCC patients with high mortality. Patients and Methods: This multicenter cohort study included 746 EPCC (age > 65 years) with a mean age of 72.00 ± 5.24 years, of whom 489 (65.5%) were male. The cut-off value for the inflammation index was obtained using the optimal survival curve. The different inflammatory indicators were assessed using the concordance index (C-index), decision curve analysis (DCA), and prognostic receiver operating characteristic (ROC). The high mortality risk group of EPCC was defined by the 2011 Fearon Cancer Diagnostic Consensus. EPCC were divided into the high-risk group, which satisfies three diagnostic criteria, and a low-risk group, which satisfies only one or two diagnostic criteria. Results: The C-index, DCA, and prognostic ROC indicated the superiority of advanced lung cancer inflammation index (ALI) compared with other indicators, including neutrophil–lymphocyte ratio (NLR), prognostic nutritional index (PNI), systemic immune-inflammation index (SII), and platelet–lymphocyte ratio (PLR). Whether ALI was used as a continuous or a categorical variable, ALI had a better prognostic value in EPCC compared with ...