Inflammation-Based Markers of Nutrition in Cancer Patients

Abstract

Malnutrition and cachexia are common findings in cancer patients, and they predict poorer clinical outcomes. Close to half of cancer patients regardless of cancer type have malnutrition and will require one form of nutritional support either before or during treatment. The early identification of malnutrition is thus important to physicians and caregivers. The role of inflammation in the development and progression of malnutrition and cachexia is being unravelled. Increasing evidence shows that systemic inflammatory response and nutritional status are involved in tumour development and influence the clinical prognosis. Serum proteins such as albumin and prealbumin have traditionally been used by physicians to determine patient nutritional status. More recently, inflammation-based prognostic scores including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), C reactive protein-to-albumin ratio (CAR), prognostic nutritional index (PNI), Glasgow Prognostic Score (GPS) have shown promise and have begun to be used in clinical practice to predict prognosis of cancer patients. This chapter highlights the role and pathophysiology of inflammation-based markers in assessing malnutrition and cachexia and their relationship to clinical screening tools.