Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
AI Summary:
The cachexia index (CXI) was found to be associated with disease progression, worse postoperative mortality, and overall survival in patients with locally advanced oesophagogastric cancer.AI Topics:
Background Features of cancer cachexia adversely influence patient outcomes, yet few currently inform clinical decision-making. This study assessed the value of the cachexia index (CXI), a novel prognostic marker, in patients for whom neoadjuvant chemotherapy and surgery for oesophagogastric cancer is planned. Methods Consecutive patients newly diagnosed with locally advanced (T3–4 or at least N1) oesophagogastric cancer between 1 January 2010 and 31 December 2015 were identified through the West of Scotland and South-East Scotland Cancer Networks. CXI was calculated as (L3 skeletal muscle index) × (serum albumin)/(neutrophil lymphocyte ratio). Sex-stratified cut-off values were determined based on the area under the curve (AUC), and patients were divided into groups with low or normal CXI. Primary outcomes were disease progression during neoadjuvant chemotherapy and overall survival (at least 5 years of follow-up). Results Overall, 385 patients (72% men, median age 66 years) were treated with neoadjuvant chemotherapy for oesophageal (274) or gastric (111) cancer across the study interval. Although patients with a low CXI (men: CXI below 52 (AUC 0.707); women: CXI below 41 (AUC 0.759)) were older with more co-morbidity, disease characteristics were comparable to those in patients with a normal CXI. Rates of disease progression during neoadjuvant chemotherapy, leading to inoperability, were higher in patients with a low CXI (28 versus 12%; adjusted OR 3.07, 95% c.i. 1.67 to 5.64; P < 0.001). Low CXI was associated with worsened postoperative mortality (P = 0.019) and decreased overall survival (median 14.9 versus 56.9 months; adjusted HR 1.85, 1.42 to 2.42; P < 0.001). Conclusion CXI is associated with disease progression, worse postoperative mortality, and overall survival, and could improve prognostication and decision-making in patients with locally advanced oesophagogastric cancer.
Brown, Leo R.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
Vagnildhaug, Ola Magne and Balstad, Trude R. and Ottestad, Inger and Bye, Asta and Greil, Christine and Arends, Jann and Baracos, Vickie and Brown, Leo R. and Dajani, Olav F. and Dolan, Ross D. and Fallon, Marie and Fraser, Eilidh and Grzyb, Aleksandra and Hjermstad, Marianne J. and Jakobsen, Gunnhild and Kaasa, Stein and McDonald, James and Philips, Iain and Sayers, Judith and Simpson, Melanie R. and Sousa, Mariana S. and Skipworth, Richard J.E. and Laird, Barry J.A. and Solheim, Tora S. and Cancer Cachexia Endpoints Working Group (2024) Appetite and dietary intake endpoints in cancer cachexia clinical trials: Systematic Review 2 of the cachexia endpoints series. Journal of Cachexia, Sarcopenia and Muscle, 15 (2). pp. 513-535. ISSN 2190-5991
See full publications listThomson, Georgina G.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listGardner, Ellen
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listChien, Siobhan
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listMcGovern, Josh
Author
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Golder, Allan M. and Ferguson, Michael and McMillan, Paul and Mansouri, David and Horgan, Paul G. and Roxburgh, Campbell S. and Dolan, Ross D. and McGovern, Josh and McMillan, Donald (2024) CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer. Scientific Reports, 14: 15673. ISSN 2045-2322
See full publications listDolan, Ross D.
Author
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Golder, Allan M. and Ferguson, Michael and McMillan, Paul and Mansouri, David and Horgan, Paul G. and Roxburgh, Campbell S. and Dolan, Ross D. and McGovern, Josh and McMillan, Donald (2024) CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer. Scientific Reports, 14: 15673. ISSN 2045-2322
See full publications listMcSorley, Steven T.
Author
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listForshaw, Matthew J.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listMcMillan, D.C.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listWigmore, Stephen J.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listCrumley, AndrewB.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listSkipworth, Richard J.E.
Author
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
Vagnildhaug, Ola Magne and Balstad, Trude R. and Ottestad, Inger and Bye, Asta and Greil, Christine and Arends, Jann and Baracos, Vickie and Brown, Leo R. and Dajani, Olav F. and Dolan, Ross D. and Fallon, Marie and Fraser, Eilidh and Grzyb, Aleksandra and Hjermstad, Marianne J. and Jakobsen, Gunnhild and Kaasa, Stein and McDonald, James and Philips, Iain and Sayers, Judith and Simpson, Melanie R. and Sousa, Mariana S. and Skipworth, Richard J.E. and Laird, Barry J.A. and Solheim, Tora S. and Cancer Cachexia Endpoints Working Group (2024) Appetite and dietary intake endpoints in cancer cachexia clinical trials: Systematic Review 2 of the cachexia endpoints series. Journal of Cachexia, Sarcopenia and Muscle, 15 (2). pp. 513-535. ISSN 2190-5991
See full publications listAvailable under License Creative Commons Attribution.
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