Prognostic Significance of the Cachexia Index (CXI) in Patients with Cancer: A Systematic Review and Meta-Analysis
Abstract
AIM
The Cachexia Index (CXI) was a useful indicator of malnutrition and inflammatory pressure in patients with cancer and was associated with a poor prognosis. However, the available studies differ in terms of study population, design, and the used cut-offs. Therefore, we aimed to systematically analyze the association between CXI and survival in cancer patients.
MATERIAL AND METHOD
We conducted a systematic literature search across Pubmed, Scopus, and Web of Science databases for studies published up to 24 September 2024. This protocol was registered in the PROSPERO database (Registration Number: CRD42024594228). We performed a meta-analysis and analyzed the results of these studies.
RESULTS
Twenty-two studies with a total of 5401 patients were identified. Lower CXI levels were significantly associated with shorter overall survival (OS) (Hazard Ratio (HR): 2.03, 95% Confidence Interval (CI): 1.83-2.24, p<0.001) and progression-free survival (PFS) (HR:1.86 95%CI: 1.67-2.08, p<0.001). This association was similar among tumor types (gastrointestinal (GI), hepatobiliary/pancreas, and other tumors) and tumor stage (localized vs metastatic).
CONCLUSION
In this meta-analysis, we showed a relationship between lower CXI levels and survival in patients with cancer. Our findings suggest that CXI may be a valuable prognostic marker in patients with cancer and help clinicians define high-risk patients.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,401 participants or records.
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