Cachexia index as a prognostic marker in patients undergoing biliary tract cancer resection

This study investigated the relationship between the preoperative cachexia index (CXI) and long-term outcomes in patients who underwent radical resection for biliary tract cancer (BTC).

We analyzed 128 patients who underwent BTC resection at a single institute between 2014 and 2022. The diagnoses of the patients included intrahepatic cholangiocarcinoma (n = 27), perihilar cholangiocarcinoma (n = 17), distal cholangiocarcinoma (n = 36), gallbladder carcinoma (n = 20), and ampullary cholangiocarcinoma (n = 28). The relationship between CXI and long-term outcomes after BTC resection was investigated. CXI was calculated on the basis of the preoperative skeletal muscle index, serum albumin level, and neutrophil-to-lymphocyte ratio.

The low-CXI group (36/69, 52.1%) had a significantly higher rate of lymph node metastasis than the high-CXI group (14/59, 23.7%). The multivariate analysis confirmed that lymph node metastasis, poor differentiation (poor), and inclusion in the low-CXI group were independently associated with disease-free survival (DFS) and overall survival (OS) in patients who underwent radical resection for BTC. After propensity score matching, the low-CXI group had a significantly worse prognosis than the high-CXI group in terms of both DFS and OS.

CXI may be a useful prognostic factor for DFS and OS after resection of BTC.