Assessment of nutritional status and prognosis in advanced metastatic cancer (AMC)

Abstract

8146 Background: Depletion of nutritional reserves and significant weight loss can lead to an increased risk of morbidity, reduced chemotherapy response, and shorter survival in patients (pts) with cancer. Numerous methodologies are used for the assessment of nutritional status. However, it remains unclear which of these tools is the most appropriate in the setting of cancer chemotherapy. The Prognostic Inflammatory Nutritional Index (PINI) is a simple scoring system that has been used to evaluate nutritional status and prognosis in critically ill pts. The PINI has been rarely evaluated in AMC. The aim of this study is to evaluate the interrelationships between the PINI and survival time (S), and performance status (PS) in pts with advanced solid malignancies following palliative chemotherapy. Methods: This study included 47 pts with PS (ECOG) 1–3 in AMC following palliative chemotherapy. PS, body mass index (BMI), alpha 1-acid glycoprotein (AGP), C-reactive protein (CRP), albumin (ALB), prealbumin (PALB), protein, LDH, PINI ratio [PINI = (AGP x CRP)/(ALB x PALB)], and S were evaluated. We investigated the interrelationships between PS and biochemical indices, PINI, and S. Results: In 47 pts, the median age was 60 yrs (40–69 yrs). The PS was: PS 1: 19 pts, PS 2: 17 pts, PS 3: 11 pts. The mean value of PINI was: PS 1: 7.4±13.4, PS 2: 78.0±155.0, PS 3: 145.6±173.0. The mean day of S was: PS 1: 108.8±49.6, PS 2: 50.9±20.1, PS 3: 20.2±18.3. In the PS 3 group, the mean values of AGP, and CRP were significantly higher than in the PS 1 group. In the PS 3 group, the mean values of ALB, and PALB were significantly lower than in the PS 1 group. However, BMI, Protein, and LDH were not significant. The severity of PS was correlated with the PINI (p=0.004, r=0.408), AGP (p=0.001, r=0.481), CRP (p=0.003, r=0.421), ALB (p<0.001, r=-0.517), PALB (p<0.001, r=-421), and S (p<0.001, r=-0.718). The value of PINI was correlated with S (p=0.004, r=-0.418). Conclusions: The PINI may be a useful scoring system for the assessment of nutritional status and prognosis. Altered nutritional and inflammatory status correlate with PS, and S following anticancer chemotherapy. No significant financial relationships to disclose.