Nutrition‐inflammation marker enhances prognostic value to ECOG performance status in overweight or obese patients with cancer

Abstract Background Overweight or obese cancer patients are more likely to develop a proinflammatory status. The aim of this study was to investigate whether the nutrition‐inflammation marker can provide additional prognostic information on top of well‐established Eastern Cooperative Oncology Group performance status (ECOG‐PS) in overweight or obese patients with cancer. Methods A total of 1667 overweight or obese cancer patients were enrolled in this study. We assessed the prediction accuracy of 10 nutrition‐inflammation markers by time‐dependent receiver operating characteristic (ROC) and elucidated their association with overall survival by the Kaplan‐Meier method and a Cox model. Results In this analysis, the majority of patients had a good performance status (ECOG‐PS score ≤1; 88.3%). Both the area under ROC curves and the C‐index of the lymphocyte–C‐reactive protein ratio (LCR) demonstrated that LCR was the most significant nutrition‐inflammation marker correlated with survival. In patients with good ECOG‐PS, a low LCR was significantly associated with poorer prognosisand enhanced the predictive ability of one‐year mortality. For specific tumor types, a low LCR was an independent prognostic factor for lung cancer, upper gastrointestinal cancer, and colorectal cancer, and it tended to be a significant predictor for breast cancer. In addition, those patients with a combined low LCR and poorer ECOG‐PS (ECOG‐PS score >1) showed the worst prognosis. Conclusion The LCR is more strongly associated with overall survival than other nutrition‐inflammation markers, and it is able to further detect patients with worse prognosis on top of ECOG‐PS in overweight or obese patients with cancer.