Prognostic significance of the cachexia index (CXI) in patients with cancer: A systematic review and meta-analysis

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-03-27 DOI:10.1016/j.clnesp.2025.03.023

Onur Bas , Taha Koray Sahin , Latif Karahan , Alessandro Rizzo , Deniz Can Guven

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引用次数: 0

Abstract

Aim

The Cachexia Index (CXI) was a useful indicator of malnutrition and inflammatory pressure in patients with cancer and was associated with a poor prognosis. However, the available studies differ in terms of study population, design, and the used cut-offs. Therefore, we aimed to systematically analyze the association between CXI and survival in cancer patients.

Material and method

We conducted a systematic literature search across Pubmed, Scopus, and Web of Science databases for studies published up to 24 September 2024. This protocol was registered in the PROSPERO database (Registration Number: CRD42024594228). We performed a meta-analysis and analyzed the results of these studies.

Results

Twenty-two studies with a total of 5401 patients were identified. Lower CXI levels were significantly associated with shorter overall survival (OS) (Hazard Ratio (HR): 2.03, 95 % Confidence Interval (CI): 1.83–2.24, p < 0.001) and progression-free survival (PFS) (HR:1.86 95%CI: 1.67–2.08, p < 0.001). This association was similar among tumor types (gastrointestinal (GI), hepatobiliary/pancreas, and other tumors) and tumor stage (localized vs metastatic).

Conclusion

In this meta-analysis, we showed a relationship between lower CXI levels and survival in patients with cancer. Our findings suggest that CXI may be a valuable prognostic marker in patients with cancer and help clinicians define high-risk patients.

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恶病质指数（CXI）在癌症患者中的预后意义：一项系统综述和荟萃分析。

目的：恶病质指数（CXI）是癌症患者营养不良和炎症压力的有用指标，与不良预后相关。然而，现有的研究在研究人群、设计和使用的截止值方面存在差异。因此，我们旨在系统地分析CXI与癌症患者生存之间的关系。材料和方法：我们对Pubmed、Scopus和Web of Science数据库进行了系统的文献检索，检索截止到2024年9月24日发表的研究。该协议已在PROSPERO数据库中注册（注册号：CRD42024594228）。我们进行了荟萃分析并分析了这些研究的结果。结果：22项研究共纳入5401例患者。较低的CXI水平与较短的总生存期（OS）显著相关（风险比（HR）： 2.03, 95%可信区间（CI）： 1.83-2.24）。结论：在本荟萃分析中，我们显示了较低的CXI水平与癌症患者的生存期之间的关系。我们的研究结果表明，CXI可能是癌症患者的一个有价值的预后标志物，可以帮助临床医生确定高危患者。

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

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.