Comprehensive evaluation of serum hepatic proteins in predicting prognosis among cancer patients with cachexia: an observational cohort study

Jia-Xin Huang ^1,2, Xi Zhang ^1,3,4, Meng Tang ^1,3,4

⁰Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Bmc Cancer +

|

March 4, 2024

View abstract on PubMed

Summary

Low levels of serum hepatic proteins, including albumin, prealbumin, and transferrin, are independent predictors of poor prognosis in cancer cachexia patients. Routine monitoring of these markers can help predict survival outcomes, especially in advanced stages.

Area Of Science

Oncology
Biochemistry
Clinical Medicine

Background

Hepatic proteins like albumin, prealbumin, and transferrin are established prognostic markers in various cancers.
Cancer cachexia is a complex syndrome associated with poor outcomes.
The prognostic significance of these hepatic proteins specifically in cancer cachexia requires comprehensive evaluation.

Purpose Of The Study

To assess the prognostic value of serum albumin, prealbumin, and transferrin in patients with cancer cachexia.
To compare the predictive accuracy of these three hepatic proteins for overall survival.
To identify their association with short-term mortality and quality of life.

Main Methods

A multicenter prospective cohort study involving 1303 cancer cachexia patients.
Utilized concordance index (C-index) and ROC curves to compare prognostic performance.
Employed Kaplan-Meier survival analysis and Cox proportional hazard regression models.

Main Results

Albumin demonstrated the highest predictive capacity for survival, followed by transferrin and prealbumin.
Low levels of albumin, prealbumin, and transferrin were independently associated with increased mortality risk (HRs ranging from 1.42 to 1.51).
These markers were particularly valuable in advanced stage (III/IV) cancer cachexia and predicted higher risks of 90-day mortality and impaired quality of life.

Conclusions

Serum albumin, prealbumin, and transferrin are significant independent prognostic factors in cancer cachexia.
Their prognostic value is pronounced in advanced-stage disease.
Routine measurement of these hepatic proteins is recommended for predicting prognosis in cancer cachexia patients.

Keywords:

Albumin Cachexia Cancer Prealbumin Prognosis Transferrin

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