Cancer, malnutrition and inflammatory biomarkers. Why do some cancer patients lose more weight than others?

Introduction: Malnutrition is highly prevalent in cancer patients, significantly influencing their clinical outcomes and prognosis. The study was conducted to investigate the association between inflammatory biomarkers, nutritional status and progression of the disease across various types of cancers.

Material and methods: Retrospective data from 200 consecutive Caucasian cancer patients admitted to a major oncology hospital for cancer treatment were analyzed according to age, sex, cancer type, nutritional status (percentage body weight loss - %BWL), body mass index (BMI), percentage of dietary intake from the calculated requirement for nutrients (%DI)), and laboratory results (albumin levels, total protein concentration, C-reactive protein - CRP). Inflammatory biomarkers such as prognostic nutritional index (PNI), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) were assessed.

Results: Prognostic nutritional index (ρ = -0.464, p < 0.001), PLR (ρ = 0.293, p = 0.019), albumin level (ρ = -0.490, p < 0.001), platelet count (ρ = 0.114, p = 0.370), neutrophil count (ρ = 0.273, p = 0.030), CRP (ρ = 0.293, p = 0.019) and lymphocyte count (ρ = -0.288, p = 0.021) were significantly associated with %BWL. No significant association was found with NLR. Cancer dissemination was significantly associated with PNI (OR: 0.93, 95% CI: 0.88-0.98), PLR (OR: 1.00, 95% CI: 1.00-1.01), albumin (OR: 0.86, 95% CI: 0.80-0.93), platelet count (OR: 1.01, 95% CI: 1.00-1.01), %BWL (OR: 1.06, 95% CI: 1.02-1.10) and %DI (OR: 0.97, 95% CI: 0.96-0.99) but not with NLR, total protein level, total lymphocyte count, or BMI. For patients with albumin levels below 35 g/l, the likelihood of disseminated cancer was more than five times higher (OR: 5.45, 95% CI: 2.05-14.48).

Conclusions: The intensity of inflammation may be responsible for the severity of malnutrition and cancer prognosis.