Development and applicability of modified weight loss grading system in cancer: a real-world cohort study

IF 8.9 1区医学 Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2023-07-11 DOI:10.1002/jcsm.13287

Hailun Xie, Guotian Ruan, Lishuang Wei, Heyang Zhang, Yizhong Ge, Shiqi Lin, Mengmeng Song, Qi Zhang, Xi Zhang, Ziwen Wang, Chenan Liu, Jinyu Shi, Xiaoyue Liu, Ming Yang, Xin Zheng, Yue Chen, Xiaowei Zhang, Li Deng, Hanping Shi

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Abstract

Background

The original weight loss grading system (WLGS) was developed in western population, which did not perform effectively in cancer patients from China. This study aimed to develop and validate the modified WLGS (mWLGS) in the prognostic assessment of cancer patients in China.

Methods

A prospective multicentre real-world cohort study involving 16 842 patients diagnosed with cancer was conducted. Cox regression was used to calculate the hazard ratios for overall survival. Logistic linear regression was used to assess the odds ratio for 90-day outcomes.

Results

We calculated survival risks for the 25 mWLGS groups and clustered the approximate survival risks. Finally, we revised the prognostic grading system for mWLGS to include five grades of 0–4. Compared with the original WLGS, the mWLGS had a better prognostic differentiation effect in predicting the prognosis of patients with cancer. The survival rate gradually deteriorated with increasing grade of mWLGS, with the survival rate of grade 0 decreasing from 76.4% to 48.2% for grade 4 (76.4 vs. 72.8 vs. 66.1 vs. 57.0 vs. 48.2%, respectively). The mWLGS provides effective prognostic stratification for most site-specific cancers, especially lung and gastrointestinal cancers. High-grade mWLGS is independently associated with an increased risk of poor quality of life and adverse 90-day outcomes. Multivariate Cox regression analysis showed that the mWLGS was an independent prognostic factor for cancer patients in the validation cohorts.

Conclusions

Compared with the original WLGS, the mWLGS can better stratify the prognosis of cancer patients. mWLGS is a useful tool for predicting survival, 90-day outcomes, and quality of life in patients with cancer. These analyses may provide new insights into the application of WLGS in cancer patients in China.

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癌症改良减肥分级系统的发展和适用性：一项现实世界的队列研究。

背景：最初的体重减轻分级系统（WLGS）是在西方人群中开发的，但在中国癌症患者中效果不佳。本研究旨在开发和验证改良WLGS（mWLGS）在中国癌症患者预后评估中的作用。Cox回归用于计算总生存率的危险比。Logistic线性回归用于评估90天结果的比值比。结果：我们计算了25 mWLGS组的生存风险，并对近似生存风险进行了聚类。最后，我们修订了mWLGS的预后分级系统，将0-4分为五个等级。与原始WLGS相比，mWLGS在预测癌症患者预后方面具有更好的预后分化效果。生存率随着mWLGS分级的增加而逐渐恶化，0级的生存率从76.4%降至4级的48.2%（分别为76.4对72.8对66.1对57.0对48.2%）。mWLGS为大多数位点特异性癌症，特别是肺癌和胃肠道癌症提供了有效的预后分层。高级别mWLGS与生活质量差和90天不良结果的风险增加独立相关。多因素Cox回归分析表明，mWLGS是验证队列中癌症患者的独立预后因素。结论：与原WLGS相比，mWLGS能更好地对癌症患者的预后进行分层。mWLGS是预测癌症患者生存率、90天预后和生活质量的有用工具。这些分析可能为WLGS在中国癌症患者中的应用提供新的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine

自引率

12.40%

发文量

期刊介绍： The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.