Prognostic Value of the Modified Cachexia Index in Colorectal Cancer Patients Undergoing Curative Surgery.

Cancer diagnosis & prognosis Pub Date : 2025-01-03 eCollection Date: 2025-01-01 DOI:10.21873/cdp.10416

Tsuyoshi Nishiyama, Masatsune Shibutani, Hideki Tanda, Yuki Seki, Shinichiro Kashiwagi, Hiroaki Kasashima, Tatsunari Fukuoka, Kiyoshi Maeda

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Abstract

Background/aim: The cachexia index (CXI) has been reported to be a useful indicator for predicting the prognosis of cancer patients. However, CXI calculation requires skeletal muscle index (SMI) measurements, which involves an analysis of computed tomography images using an imaging software program, which makes the calculation process highly complex and time-consuming. Recently, the modified cachexia index (mCXI), calculated using the urea-to-creatinine ratio (UCR) instead of SMI, has been reported to be a useful marker that is easier to calculate than CXI. This study aimed to evaluate the correlation between mCXI and the prognosis of patients with colorectal cancer (CRC).

Patients and methods: A total of 291 patients who underwent curative surgery for stage I-III CRC were enrolled. mCXI was calculated as the serum albumin concentration/neutrophil-to-lymphocyte ratio (NLR)/UCR. A receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value of the mCXI for predicting prognosis.

Results: The median mCXI was 0.089 (range=0.012-0.354). The ROC curve analysis revealed that the appropriate cut-off value for mCXI was 0.113. The low mCXI group had significantly shorter relapse-free and overall survival rates than the high mCXI group (p=0.030 and p=0.014, respectively).

Conclusion: mCXI, which does not require an image analysis, may be closely associated with prognosis in patients undergoing curative surgery for CRC.

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修正恶病质指数在大肠癌根治性手术患者中的预后价值。

背景/目的：恶病质指数（cachexia index， CXI）已被报道为预测癌症患者预后的有用指标。然而，CXI计算需要测量骨骼肌指数（SMI），这涉及到使用成像软件程序对计算机断层扫描图像进行分析，这使得计算过程非常复杂且耗时。最近，改良恶病质指数（mCXI）被报道为一种比CXI更容易计算的有用标记物，它使用尿素与肌酐比值（UCR）代替SMI来计算。本研究旨在评估mCXI与结直肠癌（CRC）患者预后的相关性。患者和方法：共有291例接受I-III期CRC手术治疗的患者被纳入研究。mCXI计算为血清白蛋白浓度/中性粒细胞与淋巴细胞比值(NLR)/UCR。采用受试者工作特征（ROC）曲线分析确定mCXI预测预后的最佳临界值。结果：中位mCXI为0.089（范围=0.012-0.354）。ROC曲线分析显示mCXI的合适临界值为0.113。低mCXI组的无复发生存率和总生存率明显短于高mCXI组（p=0.030和p=0.014）。结论：mCXI不需要图像分析，可能与结直肠癌根治性手术患者的预后密切相关。

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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Cancer diagnosis & prognosis

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