ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1631483
Inflammatory Score as a Predictor of Survival and Nutritional Deterioration in Cancer Patients: Insights from a Multicenter Cohort Study
Provisionally accepted
- 1Guangxi Medical University, Nanning, China
- 2Department of Gastrointestinal surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Background & Aims: Chronic inflammation is a hallmark of cancer progression. This multicenter cohort study aimed to evaluate the prognostic value of a novel inflammatory score, derived from baseline white blood cell (WBC) count and Creactive protein (CRP) z-scores, in predicting survival outcomes and nutritional deterioration among cancer patients. Methods: We analyzed data from 6,568 cancer patients across multiple institutions. The inflammatory score was categorized as mild, moderate, or severe. Kaplan-Meier survival analysis, Cox proportional hazards models, and restricted cubic splines were used to assess associations with all-cause mortality. Subgroup analyses were stratified by tumor type and pathological stage. Logistic regression models quantified associations between inflammatory scores and nutritional deterioration. Results: Dose-response analyses revealed a nonlinear relationship between continuous inflammatory scores and mortality (HR = 1.200, 95% CI: 1.163-1.238, P < 0.001). Higher inflammatory scores were significantly associated with reduced survival (67.5% vs 65.3% vs 57.0% vs 45.2%, p < 0.001). In fully adjusted models, severe inflammation conferred a 60.4% increased mortality risk (HR=1.604, 95% CI:1.464-1.757, p<0.001) compared to mild inflammation. Subgroup analyses confirmed consistent associations across tumor types and pathological stages. Advanced-stage (III/IV) patients exhibited heightened sensitivity to inflammatory burden, underscoring its role in late-stage prognosis. Severe inflammation was also linked to higher rates of severe malnutrition (OR=2.553, 95%CI:2.226-2.927, p<0.001) and cachexia (OR=2.662, 95%CI:2.323-3.049, p<0.001). Validation cohorts reproduced these findings, underscoring the score's robustness.The inflammatory score, integrating WBC and CRP, is a strong independent predictor of survival and nutritional deterioration in cancer patients. Its clinical utility for risk stratification and guiding targeted anti-inflammatory therapies warrants further exploration.
Keywords: Inflammatory score, overall survival, Malnutrition, Cachexia, Cancer
Received: 19 May 2025; Accepted: 07 Jul 2025.
Copyright: © 2025 Xie, Wang, Wei, Lin, Shi and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Junqiang Chen, Guangxi Medical University, Nanning, China
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