Dolan Ross D, Daly Louise E, Simmons Claribel Pl, Ryan Aoife M, Sim Wei Mj, Fallon Marie, Power Derek G, Wilcock Andrew, Maddocks Matthew, Bennett Michael I, Usborne Caroline, Laird Barry J, McMillan Donald C
Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow G31 2ER, UK.
School of Food and Nutritional Sciences, College of Science, Engineering and Food Science, University College Cork, Cork, Ireland.
Cancers (Basel). 2020 May 8;12(5):1187. doi: 10.3390/cancers12051187.
Cancer remains one of the leading causes of mortality worldwide and the associated reduction in physical function has a marked impact on both quality of life and survival. The aim of the present study was to examine the relationship between Eastern Cooperative Oncology Group-Performance status (ECOG-PS), modified Glasgow Prognostic Score (mGPS), Body Mass Index/ Weight Loss grade (BMI/WL grade), and Computerised Tomography (CT)-derived body composition measurement and physical function in patients with advanced cancer. Nine sites contributed prospective data on patient demographics, ECOG-PS, mGPS, physical function tests, and CT-derived body composition. Categorical variables were analysed using χ test for linear-by-linear association, or χ test for 2-by-2 tables. Associations were analysed using binary logistic regression. A total of 523 cancer patients (266 males, 257 females) were included in the final analysis and most had metastatic disease (83.2%). The median overall survival was 5.6 months. On multivariate binary logistic regression analysis, a high ECOG-PS remained independently associated with a low skeletal muscle index ( < 0.001), low skeletal muscle density ( < 0.05), and timed up and go test failure ( < 0.001). A high mGPS remained independently associated with a low skeletal muscle density ( < 0.05) and hand grip strength test failure ( < 0.01). A high BMI/WL grade remained independently associated with a low subcutaneous fat index ( < 0.05), low visceral obesity ( < 0.01), and low skeletal muscle density ( < 0.05). In conclusion, a high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer body composition and physical function in patients with advanced cancer.
癌症仍然是全球主要的死亡原因之一,与之相关的身体功能下降对生活质量和生存率都有显著影响。本研究的目的是探讨东部肿瘤协作组体能状态(ECOG-PS)、改良格拉斯哥预后评分(mGPS)、体重指数/体重减轻分级(BMI/WL分级)以及计算机断层扫描(CT)得出的身体成分测量值与晚期癌症患者身体功能之间的关系。九个研究点提供了关于患者人口统计学、ECOG-PS、mGPS、身体功能测试以及CT得出的身体成分的前瞻性数据。分类变量使用线性趋势的χ检验或2×2列联表的χ检验进行分析。关联性分析采用二元逻辑回归。最终分析纳入了523例癌症患者(266例男性,257例女性),大多数患者患有转移性疾病(83.2%)。中位总生存期为5.6个月。在多变量二元逻辑回归分析中,高ECOG-PS仍然独立地与低骨骼肌指数(<0.001)、低骨骼肌密度(<0.05)以及计时起立行走测试失败(<0.001)相关。高mGPS仍然独立地与低骨骼肌密度(<0.05)和握力测试失败(<0.01)相关。高BMI/WL分级仍然独立地与低皮下脂肪指数(<0.05)、低内脏肥胖(<0.01)和低骨骼肌密度(<0.05)相关。总之,在ECOG-PS/mGPS框架中概述的高ECOG-PS和高mGPS与晚期癌症患者较差的身体成分和身体功能始终相关。