Performance of mid-upper arm circumference and other prognostic indices based on inflammation and nutrition in oncology outpatients: a tertiary cancer center study

Yu Jung Kim, Yusuke Hiratsuka, Sang Yeon Suh, Seon Hye Won, Eun Hee Jung, Beodeul Kang, Si Won Lee, Hong Yup Ahn, Koung Jin Suh, Ji Won Kim, Se Hyun Kim, Jin Won Kim, Keun Wook Lee, Jee Hyun Kim, Jong Seok Lee

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: We aimed to compare the performance of established inflammation and nutrition-based prognostic indices with a relatively novel index ‘mid-upper arm circumference (MUAC)’ in outpatients with advanced cancer. Methods: This study was a secondary analysis of a prospective cohort study that enrolled 200 outpatients with advanced cancer visiting a medical oncology clinic at a tertiary hospital. All patients were followed until death, and the Glasgow Prognostic Score (GPS), modified GPS (mGPS), Prognostic Nutritional Index (PNI), neutrophil/lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR), and MUAC were compared by calculating the area under the receiver operating characteristic curves (AUROCs). Results: The mean age of the patients was 64.4 years, 64.0% were male, and the median overall survival was 32.4 weeks [95% confidence interval (CI): 5.6–142.7]. Overall, all indices showed similarly high AUROCs for estimating 12-week (0.68 to 0.75) and 24-week survival (0.67 to 0.74). When confined to the GPS, mGPS, and MUAC, the AUROCs for 12-week survival were 0.75 (95% CI: 0.66–0.82), 0.74 (95% CI: 0.65–0.82), and 0.72 (95% CI: 0.64–0.79), respectively. For 24-week survival, the AUROCs were 0.70 (95% CI: 0.62–0.76), 0.67 (95% CI: 0.60–0.74), and 0.72 (95% CI: 0.64–0.79), respectively. MUAC had the highest specificity for estimating 12-week survival (86.0%), while GPS showed the highest sensitivity for estimating 12-week survival (81.1%). Conclusions: Inflammation and nutrition-based prognostic indices showed similar acceptable accuracies in estimating the 12-and 24-week survival of oncology outpatients. Notably, a simple and non-invasive index MUAC, showed comparable performance with established indices including GPS and mGPS.

Original languageEnglish
Pages (from-to)3171-3180
Number of pages10
JournalAnnals of Palliative Medicine
Volume11
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • Neoplasms
  • inflammation
  • nutrition
  • prognosis
  • survival

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