ArticleJournal of cachexia, sarcopenia and muscle2023
A promising prognostic grading system incorporating weight loss and inflammation in patients with advanced cancer.
Article in Journal of cachexia, sarcopenia and muscle, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Functional Outcomes and Quality of Life for Patients With Cachexia and Solid Tumour Cancers: Findings of a Systematic Literature Review.Journal of cachexia, sarcopenia and muscle · 2026Pooled it
- Trial
- Peptide OH-CATH30 Mitigates Cachexia-Induced Muscle Atrophy via Modulation of TLR4-Associated Inflammation.Journal of cachexia, sarcopenia and muscle · 2026Article
- NLR-PALBI Score and Its Grading: Predicting Overall Survival of Patients with Primary Liver Cancer Undergoing Transcatheter Arterial Chemoembolisation.Journal of hepatocellular carcinoma · 2026Article
- The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer.BMC cancer · 2025Article
- A Nomogram for Predicting Overall Survival in Primary Central Nervous System Lymphoma: A Retrospective Study.Journal of inflammation research · 2025Article
- Comment on "A promising prognostic grading system incorporating weight loss and inflammation in patients with advanced cancer" by Zhang et al.Journal of cachexia, sarcopenia and muscle · 2024Article
- A promising prognostic grading system incorporating weight loss and inflammation in patients with advanced cancer.Journal of cachexia, sarcopenia and muscle · 2023Article
- Health-Related Quality of Life in Newly Diagnosed Cancer Patients Prior to First Outpatient Chemotherapy: A Cross-Sectional Study.SAGE open nursingArticle
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundInvoluntary weight loss and increased systemic response are frequently observed in patients with cancer, especially in advanced stages. This study aimed to develop a powerful weight loss and inflammation grading system (WLAIGS) and investigate its prognostic performance in patients with advanced cancer.
methodsThis multicentre prospective cohort study included 11 423 patients with advanced cancer. A 4 × 4 matrix representing four different per cent weight loss (WL%) categories within each of the four different neutrophil-to-lymphocyte ratio (NLR) categories (16 possible combinations of WL% and NLR) was constructed. The WLAIGS consisted of four grades, with hazard ratios (HRs) for overall survival (OS) gradually increasing from grade 1 to grade 4. Survival analyses, including Kaplan-Meier curve, Cox proportional hazards regression, and sensitivity analysis, were performed to investigate the association between WLAIGS and OS. The secondary outcomes were short-term survival, malnutrition, and quality of life. Two internal validation cohorts with a 7:3 ratio were used to validate the results.
resultsThe median age of patients with advanced cancer in our study was 59.00 (interquartile range, 50.00-66.00) years. There were 6877 (60.2%) and 4546 (39.8%) male and female participants, respectively. We totally recorded 5046 death cases during the median follow-up of 17.33 months. The Kaplan-Meier curve showed that the survival rate decreased from grade 1 to grade 4 in patients with advanced cancer (log-rank P < 0.001). The WLAIGS was an independent risk factor associated with OS adjusting for confounders, with HRs increasing from 1.20 (95% confidence interval (CI), 1.11-1.29; P < 0.001) in grade 2, 1.48 (95% CI, 1.38-1.60; P < 0.001) in grade 3 to 1.73 (95% CI, 1.58-1.89; P < 0.001) in grade 4. In each weight loss% group (2.5 ≤ WL% < 6.0; 6.0 ≤ WL% < 11.0, WL% ≥ 11.0), a NLR above 3 was associated with shorter survival and served as an independent prognostic predictor. The risk of short-term mortality, malnutrition, and poor quality of life increased with WLAIGS grade. Two internal validation cohorts confirmed that the WLAIGS independently identified the survival of patients with advanced cancer.
conclusionsThe WLAIGS, which reflects malnutrition and systemic inflammation status, is a robust and convenient tool for predicting the prognosis of patients with advanced cancer.
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