The association of fat-free mass index with mortality in cancer patients: a multicenter observational study

Menée en Chine à partir de données portant sur 1 744 patients atteints d'un cancer, cette étude de cohorte rétrospective analyse l'association entre l'indice de masse maigre et la mortalité

Résumé en anglais

Background : Low fat-free mass index (FFMI) has been related to higher mortality in community populations. However, the information on the relationship between FFMI and mortality is lacking for cancer patients. The objective of this study was to examine the association of FFMI with all-cause mortality in cancer patients.

Methods : This retrospective analysis included 1,744 cancer patients from a multicenter cohort study. The restricted cubic splines were used to flexibly model the association of FFMI with all-cause mortality. The association of low FFMI with overall survival was analyzed by the Kaplan-Meier method and a Cox model.

Results : Among all patients, there were 702 (40.3%) males and 1,042 (59.7%) females. The optimal cut‐off point of low FFMI was 16.31 for males and 14.14 for females. The FFMI showed an inverse association with all-cause mortality for males (per SD increment-HR: 0.72; 95% CI: 0.60, 0.87; P<0.001), whereas showed a nonlinear relation for females (per SD increment-HR: 0.88; 95% CI: 0.78, 0.99; P=0.048). After adjustment, low FFMI was independently associated with increased risk of mortality for both males and females. In addition, FFMI showed a strong L-shape (per SD increment-HR: 0.59; 95% CI: 0.46, 0.76; P<0.001) relation with all-cause mortality in elderly cancer patients. For specific tumor type, low FFMI was independently associated with worse prognosis in patients with lung cancer and upper gastrointestinal cancer.

Conclusions : Low FFMI was associated with all-cause mortality in cancer patients, especially for elder adults with cancer. These results highlight the usefulness of FFMI for routine clinical assessment and prognostic estimation in cancer patients.