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Low nutritional index (NRI) and high Eastern Cooperative Oncology Group Performance Status (ECOG PS) were indicative of a poorer overall survival (OS) for patients with gastric and esophageal adenocarcinoma (GEA). These findings, from a large cohort study, were presented during the ASCO20 Virtual Scientific Program.
Patients admitted to Princess Margaret Cancer Centre between 2010 and 2016 with de novo metastatic GEA were recruited. The 175 patients were assessed for NRI as determined by their weight and albumin level. Moderate to severe malnutrition was defined as NRI <97.5.
The cohort was 69% male, with a median age of 61, median body mass index (BMI) of 24.2 (range, 15.7-39.8), 79% had an ECOG PS of 0-1, and 71% had chemotherapy. Most patients (70%) lost more than 5% of their body weight in the previous 3 months and 29% were malnourished.
The median OS was 9.3 months (95% CI, 7.3-11.4). In patients who were malnourished, the OS was 5.5 months vs 10.9 months for the well-nourished patients (P =.0005). Other clinical factors observed to be indicative of a poorer prognosis in the univariate analysis were ECOG PS (P <.001), NRI (P <.001), and number of metastatic sites (P =.029). In the multivariate analysis, ECOG PS (P <.001) and NRI (P =.025) remained significant.
The presenting authors concluded that NRI and ECOG were significant predictors of a poor prognosis, and that early detection of malnourishment in patients with metastatic GEA may allow clinicians to employ nutritional intervention and support. However, further studies are needed to determine whether changes to nutrition improves clinical outcomes.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original abstract for a full list of disclosures.
Ma LX, Taylor K, Espin-Garcia O, et al. Prognostic significance of nutritional markers in metastatic gastric and esophageal adenocarcinoma. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr 4557.