VALIDATION OF A NEW PROGNOSTIC BODY COMPOSITION PARAMETER IN CANCER PATIENTS

Abstract

We evaluated the prognostic value of a new body composition parameter (creatinine height index [CHI]) obtained from bioimpedance vectorial analysis-derived body cell mass and its association with nutritional and functional status. Data of Italian and German cancer patients observed prospectively until death were used (N=1084). Multivariable models (adjusted for age, gender, hydration status, performance status, disease's stage) were built in both cohorts to assess the association between body composition outcome parameters (low fat-free mass, <15 [females] and <17 [males] kg/m2; low standardized phase angle, <-1.65; low CHI, <510 [females] and <660 [males] mg/24h/m) and 1-year all-cause mortality, low body mass index (<20 [<70 years] and <22 [>70 years] kg/m2), clinically significant weight loss (>10% in 6 months) and low handgrip strength (<20 [females] and <30 [males] kg). Low CHI was independently associated with mortality in both Italian (HR=1.84 [95%CI, 1.18-2.86]; P=0.007) and German cohorts (HR=1.52 [95%CI, 1.17-2.07]; P=0.008). Low FFMI and low SPA did not predict survival in the German cohort. In patients with low CHI, worse nutritional and functional status were observed in both study populations. Performance of models addressing the study endpoints showed substantial consistency with both cohorts, particularly of those including low CHI. We validated a new prognostic body composition parameter, which is easier to interpret than standard nutritional parameters and may be useful for identifying cancer patients at nutritional risk, requiring early nutritional support. Its prognostic value should be confirmed in other patient populations and its sensitivity in detecting changes in protein-calorie intake is still to be investigated.