Bas Onur, Sahin Taha Koray, Karahan Latif, Rizzo Alessandro, Guven Deniz Can
Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.
IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy.
Clin Nutr ESPEN. 2025 Mar 27;68:240-247. doi: 10.1016/j.clnesp.2025.03.023.
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.
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.
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).
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.
恶病质指数（CXI）是癌症患者营养不良和炎症压力的一个有用指标，且与预后不良相关。然而，现有研究在研究人群、设计和所用临界值方面存在差异。因此，我们旨在系统分析CXI与癌症患者生存率之间的关联。
我们在PubMed、Scopus和Web of Science数据库中进行了系统的文献检索，以查找截至2024年9月24日发表的研究。该方案已在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。
共纳入22项研究，涉及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%置信区间（CI）：1.83 - 2.24，p < 0.001）和无进展生存期（PFS）（HR：1.86，95%CI：1.67 - 2.08，p < 0.001）。这种关联在肿瘤类型（胃肠道（GI）、肝胆/胰腺和其他肿瘤）和肿瘤分期（局限性与转移性）之间相似。
在这项荟萃分析中，我们显示了较低的CXI水平与癌症患者生存率之间的关系。我们的研究结果表明，CXI可能是癌症患者一个有价值的预后标志物，并有助于临床医生定义高危患者。
