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

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

Clinical impact of cachexia biomarkers in advanced cancer

“…By comparing levels of inflammation with muscle mass, Kim et al were investigating the proposed mechanism of inflammation with MUAC as an assessment of muscle loss, as an end organ effect of cachexia (1). Although several definitions of cachexia exist, they have common features including elevated systemic inflammation, functional decline, unintended weight loss and muscle loss (3)(4)(5).…”

“…It is common in advanced cancer, particularly lung cancer, upper gastrointestinal and pancreatic cancer. Kim et al's study is part of a growing body of work that show associated measures of cachexia have a prognostic role in patients with cancer (1,2,(6)(7)(8)(9).…”

“…The appeal of the work by Kim et al is its simplicity (1). In this study, a quick and easy physical measurement, using mid-upper arm circumference (MUAC), is compared to established inflammatory markers as a potential prognostic tool.…”