One-Year Mortality in Patients with Cancer Cachexia: Association with Albumin and Total Protein

• Main Authors: Liu XY, Zhang X, Ruan GT, Zhang KP, Tang M, Zhang Q, Song MM, Zhang XW, Ge YZ, Yang M, Xu HX, Song CH, Shi HP
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-08-01
• Series: Cancer Management and Research
• Subjects: nutrition; survival; death; cachectic patients
• Online Access: https://www.dovepress.com/one-year-mortality-in-patients-with-cancer-cachexia-association-with-a-peer-reviewed-fulltext-article-CMAR
• ISSN: 1179-1322

Xiao-Yue Liu,1– 4,&ast; Xi Zhang,1– 3,5,&ast; Guo-Tian Ruan,1– 3 Kang-Ping Zhang,1– 3 Meng Tang,1– 3 Qi Zhang,1– 3 Meng-Meng Song,1– 3 Xiao-Wei Zhang,1– 3 Yi-Zhong Ge,1– 3 Ming Yang,1– 3 Hong-Xia Xu,6 Chun-Hua Song,7 Han-Ping Shi1– 3 1Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of China; 2Department of Oncology, Capital Medical University, Beijing, 100038, People’s Republic of China; 3Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, People’s Republic of China; 4School of Clinical Medicine, Hebei University, Baoding, 071000, People’s Republic of China; 5Department of Radiotherapy, Affiliated Hospital of Hebei University, Baoding, 071000, People’s Republic of China; 6Department of Clinical Nutrition, Daping Hospital, Army Medical University, Chongqing, 400042, People’s Republic of China; 7Department of Epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Han-Ping ShiDepartment of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People’s Republic of ChinaEmail [e-mail]: Serum albumin can indicate the onset of cancer cachexia, provide information about a patient’s nutritional status, and serve as a biomarker for the prognosis of patients with cancer cachexia. However, the relationship between serum albumin levels and mortality in patients with cancer cachexia remains unclear. We aimed to examine the association of albumin and total protein with 1-year mortality in patients with cancer cachexia.Patients and Methods: We conducted a nested case–control study using data from a multicenter cancer clinical survey from 2013 to 2018. In total, 266 patients with cancer cachexia who survived for < 1 year and 266 patients who survived for ≥ 1 year were included in this study. The participants were matched by age, sex, tumor type, tumor stage, and hospital site. The crude and adjusted risks of 1-year survival were estimated using odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression, with or without adjustment for covariates.Results: Logistic regression analysis revealed a significantly negative linear association between albumin level and 1-year mortality in patients with cancer cachexia (p < 0.001). An L-shaped relationship existed between total protein and 1-year mortality, with a turning point at 70.4 g/L. When albumin was divided into quartiles, Q3 (OR: 0.40; 95% CI: 0.24, 0.68; p < 0.001) and Q4 (OR: 0.33; 95% CI: 0.19, 0.55; p < 0.001) were associated with higher 1-year survival than Q1 among patients with cancer cachexia. When total protein was divided into quartiles, Q2 (OR: 0.38; 95% CI: 0.23, 0.64; p < 0.001), Q3 (OR: 0.57; 95% CI: 0.33, 0.96; p = 0.035), and Q4 (OR: 0.43; 95% CI: 0.25, 0.72; p = 0.002) were associated with higher 1-year survival than Q1 among patients with cancer cachexia.Conclusion: Serum albumin and total protein may predict 1-year survival. Future clinical studies should lead to a more comprehensive understanding of the effects of serum protein levels in patients with cancer cachexia.Keywords: nutrition, survival, death, cachectic patients