Clinical significance of cachexia index determined by bioelectrical impedance analysis in patients with gastrointestinal cancer

Cancer cachexia is a complex disorder characterized by skeletal muscle loss, which may influence the prognosis of patients with cancer. The cachexia index (CXI) is a new index for cachexia. The present study aimed to assess whether the CXI determined by bioelectrical impedance analysis (BIA) is valuable for predicting survival in patients with gastrointestinal cancer. A total of 54 patients with gastrointestinal cancer undergoing BIA at the time of diagnosis at Fukuchiyama City Hospital (Kyoto, Japan) were retrospectively recruited. CXI values were calculated as follows: CXI=skeletal muscle index (SMI) × serum albumin concentration/neutrophil-to-lymphocyte ratio. The SMI was measured using BIA values. The patients were classified into low- and high-CXI groups. The median patient age was 72 years and 63.0% of patients were male. A total of 20 patients with colorectal cancer were enrolled, 12 with pancreatic cancer, 11 with gastric cancer, 6 with esophageal cancer, 4 with biliary tract cancer and 1 with liver cancer. The cumulative one-year overall survival (OS) rate was significantly worse in the low-CXI group compared with that in the high-CXI group (58.3 vs. 88.5%; P=0.012). By contrast, the SMI had no significant effect on OS. Thus, CXI values using BIA may predict survival in patients with gastrointestinal cancer.