The relationship between ECOG-PS, mGPS, BMI/WL grade and body composition and physical function in patients with advanced cancer

Fallon, Marie; Dolan, Ross D.; Daly, Louise E.; Simmons, Claribel P. L.; Wilcock, Andrew; Usborne, Caroline; Bennett, Michael I.; Ryan, Aoife M.; Sim, Wei M. J.; Power, Derek G.; Laird, Barry J.; McMillan, Donald C.; Maddocks, Matthew

Abstract

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. Cancer remains one of the leading causes of mortality worldwide and the associated reduction in physical function has a marked impact on both quality of life and survival. The aim of the present study was to examine the relationship between Eastern Cooperative Oncology Group- Performance status (ECOG-PS), modified Glasgow Prognostic Score (mGPS), Body Mass Index/ Weight Loss grade (BMI/WL grade), and Computerised Tomography (CT)-derived body composition measurement and physical function in patients with advanced cancer. Nine sites contributed prospective data on patient demographics, ECOG-PS, mGPS, physical function tests, and CT-derived body composition. Categorical variables were analysed using X2 test for linear-bylinear association, or X2 test for 2-by-2 tables. Associations were analysed using binary logistic regression. A total of 523 cancer patients (266 males, 257 females) were included in the final analysis and most had metastatic disease (83.2%). The median overall survival was 5.6 months. On multivariate binary logistic regression analysis, a high ECOG-PS remained independently associated with a low skeletal muscle index (p < 0.001), low skeletal muscle density (p < 0.05), and timed up and go test failure (p < 0.001). A high mGPS remained independently associated with a low skeletal muscle density (p < 0.05) and hand grip strength test failure (p < 0.01). A high BMI/WL grade remained independently associated with a low subcutaneous fat index (p < 0.05), low visceral obesity (p < 0.01), and low skeletal muscle density (p < 0.05). In conclusion, a high ECOG-PS and a high mGPS as outlined in the ECOG-PS/mGPS framework were consistently associated with poorer body composition and physical function in patients with advanced cancer.

Citation

Fallon, M., Dolan, R. D., Daly, L. E., Simmons, C. P. L., Wilcock, A., Usborne, C., …Maddocks, M. (2020). The relationship between ECOG-PS, mGPS, BMI/WL grade and body composition and physical function in patients with advanced cancer. Cancers, 12(5), Article 1187. https://doi.org/10.3390/cancers12051187

• Journal Article Type: Article
• Acceptance Date: May 4, 2020
• Online Publication Date: May 8, 2020
• Publication Date: May 1, 2020
• Deposit Date: Jun 9, 2020
• Publicly Available Date: Jun 9, 2020
• Journal: Cancers
• Electronic ISSN: 2072-6694
• Publisher: MDPI
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 5
• Article Number: 1187
• DOI: https://doi.org/10.3390/cancers12051187
• Keywords: Cancer Research; Oncology
• Public URL: https://nottingham-repository.worktribe.com/output/4612346
• Publisher URL: https://www.mdpi.com/2072-6694/12/5