Dolan, R. D. , Daly, L., Sim, W. M.J., Fallon, M., Ryan, A., McMillan, D. C. and Laird, B. J. (2020) Comparison of the prognostic value of ECOG-PS, mGPS and BMI/WL: implications for a clinically important framework in the assessment and treatment of advanced cancer. Clinical Nutrition, 39(9), pp. 2889-2895. (doi: 10.1016/j.clnu.2019.12.024) (PMID:31926762)
Text
208833.pdf - Accepted Version Available under License Creative Commons Attribution Non-commercial No Derivatives. 546kB |
Abstract
BACKGROUND AND AIMS:The systemic inflammatory response is associated with the loss of lean tissue, anorexia, weakness, fatigue and reduced survival in patients with advanced cancer and therefore is important in the definition of cancer cachexia. The aim of the present study was to carry out a direct comparison of the prognostic value of Eastern Cooperative Oncology Group Performance Status (ECOG-PS), modified Glasgow Prognostic Score (mGPS) and Body Mass Index/Weight Loss Grade (BMI/WL grade) in patients with advanced cancer. METHOD:All data were collected prospectively across 18 sites in the UK and Ireland. Patient's age, sex, ECOG-PS, mGPS and BMI/WL grade were recorded, as were details of underlying disease including metastases. Survival data were analysed using univariate and multivariate Cox regression. RESULTS:A total of 730 patients were assessed. The majority of patients were male (53%), over 65 years of age (56%), had an ECOG-PS>0/1 (56%), mGPS≥1 (56%), BMI≥25 (51%), <2.5% weight loss (57%) and had metastatic disease (86%). On multivariate cox regression analysis ECOG-PS (HR 1.61 95%CI 1.42-1.83, p < 0.001), mGPS (HR 1.53, 95%CI 1.39-1.69, p < 0.001) and BMI/WL grade (HR 1.41, 95%CI 1.25-1.60, p < 0.001) remained independently associated with overall survival. In patients with a BMI/WL grade 0/1 both ECOG and mGPS remained independently associated with overall survival. CONCLUSION:The ECOG/mGPS framework may form the basis of risk stratification of survival in patients with advanced cancer.
Item Type: | Articles |
---|---|
Keywords: | Advanced cancer, body composition, ECOG, Glasgow prognostic score, physical function testing, systemic inflammation. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | McMillan, Professor Donald and Dolan, Dr Ross |
Authors: | Dolan, R. D., Daly, L., Sim, W. M.J., Fallon, M., Ryan, A., McMillan, D. C., and Laird, B. J. |
College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Clinical Nutrition |
Publisher: | Elsevier |
ISSN: | 0261-5614 |
ISSN (Online): | 1532-1983 |
Published Online: | 27 December 2019 |
Copyright Holders: | Copyright © 2020 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism |
First Published: | First published in Clinical Nutrition 39(9): 2889-2895 |
Publisher Policy: | Reproduced in accordance with the publisher copyright policy |
University Staff: Request a correction | Enlighten Editors: Update this record