P353 - PROGNOSTIC VALUE OF GLIM-BASED CACHEXIA CRITERIA PROPOSED BY ESMO IN PATIENTS WITH GASTROINTESTINAL CANCERS

P353

PROGNOSTIC VALUE OF GLIM-BASED CACHEXIA CRITERIA PROPOSED BY ESMO IN PATIENTS WITH GASTROINTESTINAL CANCERS

N. Mori^1,*, K. Maeda²

¹Department of Palliative and Supportive Medicine, Aichi Medical University, ²Nutrition Therapy Support Center, Aichi Medical University Hospital, Nagakute, Japan

Rationale: The ESMO guidelines for cancer cachexia (Arends et al., 2021) recommend the use of the Global Leadership Initiative on Malnutrition (GLIM) criteria for cachexia diagnosis. However, few clinical studies have validated this approach. This study aimed to evaluate the prognostic impact of GLIM-based cachexia criteria proposed by ESMO in patients with gastrointestinal cancers.

Methods: We conducted a retrospective study of adult patients with gastrointestinal cancers who were referred to the palliative care team of a university hospital between October 2021 and June 2023. At the initial consultation, patients were assessed using the GLIM criteria. Cachexia (Cx(+)) was defined as the presence of at least one phenotypic GLIM criterion along with elevated inflammation (CRP > 0.5 mg/dL). Patients not meeting these criteria were classified as Cx(−). Survival outcomes were analyzed using the log-rank test and Cox proportional hazards model.

Results: A total of 254 patients were included (61.8% male, median age 73 years): 64 (25.2%) with upper GI cancers, 64 (25.2%) lower GI, 39 (15.4%) hepatobiliary, and 87 (34.3%) pancreatic. Of these, 201 patients were classified as Cx(+) and 53 as Cx(−). Kaplan-Meier analysis revealed significantly shorter median survival in the Cx(+) group (68 days; 95% CI, 54–96) compared to the Cx(−) group (389 days; 95% CI, 234–552) (log-rank test, P < 0.001). In multivariable Cox regression adjusting for age, sex, performance status (PS ≥ 3), edema, and cancer type, Cx(+) remained independently associated with increased mortality risk (HR 2.38; 95% CI, 1.58–3.56; P < 0.001).

Conclusion: The GLIM-based cachexia criteria proposed by ESMO may serve as a useful prognostic tool in patients with gastrointestinal cancers. This diagnostic approach demonstrates clinical utility and may contribute to improved management strategies, pending further validation.

Disclosure of Interest: None declared