Patients were divided into two groups around the median of 35 into stage I cachexia (CXI ≥35) and stage II cachexia (CXI <35). There was no statistical difference between the two groups in terms of age, gender, race, and tumor histology. Patients with stage I cachexia had better PS and fewer sites of metastatic disease. They were more likely to receive chemotherapy. They also had a better response to chemotherapy.
The median PFS and OS for stage I cachexia were 5.4 and 8.8 months as opposed to 2.45 and 3.45 months for stage II cachexia (P = 0.0001) (Table 2; Fig. 1). The CXI was able to predict poor outcome in both men and women.
Patients with stage II cachexia had a poor outcome irrespective of patient’s gender. PFS in stage II cachexia for both men (2.45 months) and women (2.18 months) was worse than that of men (5.49 months) and women (4.75 months) with stage I cachexia (P < 0.001).
Click here to enlarge Figure 1
Similarly patients with stage II cachexia had a worse OS for both men (3.27 months) and women (4.62 months) than men (8.88 months) and women (7.88 months) with stage I cachexia (P = 0.001) (Table 4; Fig. 2). When patients with weight loss (>5%) were compared with those with <5% or no weight loss, there was no difference in OS (P = 0.72).
Similarly, when patients with BMI ≤20 were compared with those with BMI >20, there was no difference in OS between the two groups (P = 0.45). On univariate analysis, PS 0–1 was associated with better PFS (HR 0.46, 95% confidence interval [CI] 0.27–0.79 P = 0.0048) and OS (HR 0.41, 95% CI 0.21–0.79, P = 0.0081).