{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:38:57Z","timestamp":1783989537548,"version":"3.55.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000692","name":"Royal College of Surgeons","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000692","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018837","name":"NES","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018837","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014589","name":"CSO","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014589","id-type":"DOI","asserted-by":"publisher"}]},{"name":"NHS Research Scotland"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Features of cancer cachexia adversely influence patient outcomes, yet few currently inform clinical decision-making. This study assessed the value of the cachexia index (CXI), a novel prognostic marker, in patients for whom neoadjuvant chemotherapy and surgery for oesophagogastric cancer is planned.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Consecutive patients newly diagnosed with locally advanced (T3\u20134 or at least N1) oesophagogastric cancer between 1 January 2010 and 31 December 2015 were identified through the West of Scotland and South-East Scotland Cancer Networks. CXI was calculated as (L3 skeletal muscle index) \u00d7 (serum albumin)\/(neutrophil lymphocyte ratio). Sex-stratified cut-off values were determined based on the area under the curve (AUC), and patients were divided into groups with low or normal CXI. Primary outcomes were disease progression during neoadjuvant chemotherapy and overall survival (at least 5 years of follow-up).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall, 385 patients (72% men, median age 66 years) were treated with neoadjuvant chemotherapy for oesophageal (274) or gastric (111) cancer across the study interval. Although patients with a low CXI (men: CXI below 52 (AUC 0.707); women: CXI below 41 (AUC 0.759)) were older with more co-morbidity, disease characteristics were comparable to those in patients with a normal CXI. Rates of disease progression during neoadjuvant chemotherapy, leading to inoperability, were higher in patients with a low CXI (28 versus 12%; adjusted OR 3.07, 95% c.i. 1.67 to 5.64; P &lt; 0.001). Low CXI was associated with worsened postoperative mortality (P = 0.019) and decreased overall survival (median 14.9 versus 56.9 months; adjusted HR 1.85, 1.42 to 2.42; P &lt; 0.001).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n CXI is associated with disease progression, worse postoperative mortality, and overall survival, and could improve prognostication and decision-making in patients with locally advanced oesophagogastric cancer.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/bjs\/znae098","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T20:14:02Z","timestamp":1712693642000},"source":"Crossref","is-referenced-by-count":22,"title":["Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study"],"prefix":"10.1093","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6181-7020","authenticated-orcid":false,"given":"Leo R","family":"Brown","sequence":"first","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh , Edinburgh , UK"},{"name":"Department of General Surgery, Forth Valley Royal Hospital , Larbert , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina G","family":"Thomson","sequence":"additional","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Forth Valley Royal Hospital , Larbert , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siobhan","family":"Chien","sequence":"additional","affiliation":[{"name":"Centre for Sustainable Delivery, Golden Jubilee Hospital , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"McGovern","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross D","family":"Dolan","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen T","family":"McSorley","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Forshaw","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald C","family":"McMillan","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J","family":"Wigmore","sequence":"additional","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew B","family":"Crumley","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Forth Valley Royal Hospital , Larbert , UK"},{"name":"Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary , Glasgow , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1428-4078","authenticated-orcid":false,"given":"Richard J E","family":"Skipworth","sequence":"additional","affiliation":[{"name":"Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh , Edinburgh , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,4,9]]},"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/111\/4\/znae098\/57350914\/znae098.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/111\/4\/znae098\/57350914\/znae098.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,29]],"date-time":"2024-04-29T12:15:33Z","timestamp":1714392933000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znae098\/7642778"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":0,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,9]]},"published-print":{"date-parts":[[2024,4,3]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znae098","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,4]]},"published":{"date-parts":[[2024,4]]},"article-number":"znae098"}}