PP298 - SYSTEMIC INFLAMMATION MEDIATES THE RELATIONSHIP OF FRAILTY WITH OVERALL SURVIVAL IN PATIENTS WITH GASTROINTESTINAL CANCERS
PP298
SYSTEMIC INFLAMMATION MEDIATES THE RELATIONSHIP OF FRAILTY WITH OVERALL SURVIVAL IN PATIENTS WITH GASTROINTESTINAL CANCERS
Y.-L. Lu1,*, X. Zhang1,2,3, M.-H. Cong1
1Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 2Key Laboratory of Cancer FSMP for State Market Regulation, 3Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
Rationale: Frailty is common in gastrointestinal cancer patients and is linked to poor prognosis and increased mortality. Systemic inflammation may contribute to cancer-related frailty. This study aimed to explore the relationship between systemic inflammation (mGPS) and frailty (FFP) across various gastrointestinal tumor types and the entire adult age spectrum, and to determine whether these factors could predict patient survival.
Methods: A total of 3,431 gastrointestinal cancer patients from the INSCOC cohort (2013-2020) were included. Multivariate logistic regression assessed frailty and mGPS association. Survival analyses evaluated the impact of frailty and mGPS on overall survival (OS), and mediation analysis examined the role of inflammation in the frailty-OS relationship.
Results: The median age of the patients was 67 years (interquartile range [IQR] 58–73), with 68.4% male and 31.6% female. Logistic regression showed that frailty risk increased by 1.36 times (95% confidence interval [CI]: 1.10–1.67, P = 0.004) for mGPS of 1 and 2.06 times (95% CI: 1.65–2.56, P < 0.001) for mGPS of 2 compared to mGPS of 0. Frailty and mGPS of 2 independently predicted poorer OS, with hazard ratios (HR) of 1.76 (95% CI: 1.35–2.28) and 1.51 (95% CI: 1.28–1.78), respectively. Combined FFP and mGPS stratification revealed that patients with both frailty and mGPS of 2 had the highest mortality risk (HR = 2.83, 95% CI: 2.00–4.01, P < 0.001). Inflammation significantly mediated the relationship between frailty and OS (proportion mediated = 13.64%, 95% CI: 6.86%–26.70%, P < 0.001).
Conclusion: Systemic inflammation was significantly associated with frailty and mediated the frailty-survival relationship in gastrointestinal cancer patients, with frail patients and elevated inflammation showing significantly poorer survival.
Disclosure of Interest: None declared