Cachexia index as a Biomarker for Cancer Cachexia and Quality of Life in Gastric Cancer: Study

Cachexia, a multifaceted metabolic syndrome involving intense muscle wasting and weight loss, is well recognized to be connected with unfavorable clinical outcomes in GC patients. In the present study, CXI was calculated according to the following formula: skeletal muscle index (SMI) × serum albumin / neutrophil–lymphocyte ratio (NLR). The present study was conducted to determine if CXI could efficiently detect cachexia and foretell HRQoL impairments. The analysis involved 431 patients with GC, made up of 309 men (71.7%) and 122 women (28.3%), with an age at median of 68 years. Diagnosis of cachexia was made according to both AWGC criteria and Fearon's criteria. Univariate logistic regression and multivariate logistic regression analyses were employed to determine independent risk factors for cachexia and for poor HRQoL. ROC curve analysis was conducted to establish diagnostic performance of CXI in diagnosing cachexia, as well as calculate the area under the curve (AUC). Results • CXI scores were much lower in cachexia patients than in non-cachexia patients, according to both AWGC and Fearon's definitions (p < 0.001). • CXI was independently related to AWGC-defined cachexia after controlling for confounding variables (OR = 0.98, 95% CI: 0.97–0.99, p < 0.001) but was not related to Fearon-defined cachexia (OR = 1.00, 95% CI: 0.99–1.01, p = 0.601). • ROC analysis identified an AUC of 0.752 for men and 0.717 for women in detection of AWGC-defined cachexia, with best cut-off scores of 74.46 and 43.80 respectively. • Patients with low scores on CXI had more severe impairment on several HRQoL domains, and low CXI was independently linked with compromised HRQoL (OR = 1.79, 95% CI: 1.05–3.07, p = 0.033). The research concluded that cachexia index is a useful and trustworthy biomarker for the diagnosis of cachexia according to AWGC criteria and for the prediction of poor HRQoL in gastric cancer patients. The integration of CXI into clinical practice would potentially improve patient surveillance and inform early interventions directed at enhancing survival as well as quality of life. Reference: Huang, Y., Huang, Z., Hou, W. et al. Cachexia index as a biomarker for cancer cachexia and quality of life in patients with gastric cancer. BMC Cancer 25, 1293 (2025). https://doi.org/10.1186/s12885-025-14752-2