{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:16:48Z","timestamp":1788239808906,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T00:00:00Z","timestamp":1787961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1 TR000064"],"award-info":[{"award-number":["UL1 TR000064"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"crossref","award":["UL1 TR001427"],"award-info":[{"award-number":["UL1 TR001427"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"crossref"}]},{"award":["UL1 TR000064"],"award-info":[{"award-number":["UL1 TR000064"]}],"id":[{"id":"https:\/\/ror.org\/04pw6fb54","id-type":"ROR","asserted-by":"publisher"}]},{"award":["UL1 TR001427"],"award-info":[{"award-number":["UL1 TR001427"]}],"id":[{"id":"https:\/\/ror.org\/04pw6fb54","id-type":"ROR","asserted-by":"publisher"}]},{"name":"National Cancer Institute (NCI) of the National Institutes of Health","award":["U54CA233396"],"award-info":[{"award-number":["U54CA233396"]}]},{"name":"National Cancer Institute (NCI) of the National Institutes of Health","award":["U54CA233444"],"award-info":[{"award-number":["U54CA233444"]}]},{"name":"National Cancer Institute (NCI) of the National Institutes of Health","award":["U54CA233465"],"award-info":[{"award-number":["U54CA233465"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: This study examined whether the high-sensitivity modified Glasgow Prognostic Score (hs-mGPS) and daily weight change by percentile (DWtCP) are associated with overall survival in patients with gastrointestinal (GI) cancers, overall and across BMI categories. Methods: We analyzed de-identified electronic health record data from 176 patients with GI cancers who had albumin, high-sensitivity C-reactive protein (hs-CRP), and longitudinal weight measurements. hs-mGPS was calculated from baseline albumin and hs-CRP. DWtCP, derived from serial weight measurements, was categorized as weight gain, moderate weight loss, or severe weight loss. Survival was evaluated using Kaplan\u2013Meier and Cox proportional hazards models. Results: Nearly 70% of patients had hs-mGPS = 2, which was associated with poorer survival in the earlier part of follow-up (Breslow p = 0.011; log-rank p = 0.062), a pattern also observed in the high-BMI group (Breslow p = 0.045; log-rank p = 0.059). DWtCP was strongly associated with survival (log-rank p &lt; 0.001; Breslow p &lt; 0.001). Patients with moderate weight loss had the most favorable 1200-day Kaplan\u2013Meier survival estimate (54.6%), compared with 5.1% for severe weight loss and 10.9% for weight gain. In multivariable analysis, moderate weight loss was associated with substantially lower mortality risk than weight gain (HR = 0.194, p &lt; 0.001). In BMI-stratified models, DWtCP and primary cancer site remained independent predictors, whereas albumin and hs-CRP did not reach statistical individual significance, supporting the value of the composite hs-mGPS score. Conclusions: In this real-world retrospective cohort, hs-mGPS and DWtCP provided complementary prognostic information. Routine monitoring of systemic inflammation and longitudinal weight trajectories may enable pragmatic risk stratification and early identification of high-risk patients, particularly those with elevated BMI.<\/jats:p>","DOI":"10.3390\/cancers18172808","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T04:24:03Z","timestamp":1788150243000},"page":"2808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Systemic Inflammation and Longitudinal Weight Trajectories Improves Prognostic Stratification in Gastrointestinal Cancers: A Real-World Retrospective Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5669-8709","authenticated-orcid":false,"given":"Saunjoo L.","family":"Yoon","sequence":"first","affiliation":[{"name":"Center for Palliative Care Research and Education, Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6575-452X","authenticated-orcid":false,"given":"Jung A","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Nursing, Hanyang University, Seoul 04763, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2302-8949","authenticated-orcid":false,"given":"Oliver","family":"Grundmann","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Debra","family":"Lynch-Kelly","sequence":"additional","affiliation":[{"name":"Loewenberg College of Nursing, University of Memphis, Memphis, TN 38152, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6249-9180","authenticated-orcid":false,"given":"Thomas J.","family":"George","sequence":"additional","affiliation":[{"name":"Division of Hematology & Oncology, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,29]]},"reference":[{"key":"ref_1","first-page":"e70043","article-title":"Cancer statistics, 2026","volume":"76","author":"Siegel","year":"2026","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S1470-2045(10)70218-7","article-title":"Definition and classification of cancer cachexia: An international consensus","volume":"12","author":"Fearon","year":"2011","journal-title":"Lancet Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17105","DOI":"10.1038\/nrdp.2017.105","article-title":"Cancer-associated cachexia","volume":"4","author":"Baracos","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","first-page":"1871","article-title":"A cross-sectional study examining the prevalence of cachexia and areas of unmet need in patients with cancer","volume":"26","author":"Vagnildhaug","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1002\/jcsm.12398","article-title":"Predicting unintentional weight loss in patients with gastrointestinal cancer","volume":"10","author":"Yoon","year":"2019","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.clnesp.2025.03.027","article-title":"The Global Leadership Initiative on Malnutrition (GLIM) inflammation criteria to predict survival in patients with advanced cancer: A prospective cohort study","volume":"67","author":"Pumtako","year":"2025","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"De Felice, F., Malerba, S., Nardone, V., Salvestrini, V., Calomino, N., Testini, M., Boccardi, V., Desideri, I., Gentili, C., and De Luca, R. (2025). Progress and Challenges in Integrating Nutritional Care into Oncology Practice: Results from a National Survey on Behalf of the NutriOnc Research Group. Nutrients, 17.","DOI":"10.3390\/nu17010188"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.metabol.2019.01.007","article-title":"Association between obesity and biomarkers of inflammation and metabolism with cancer mortality in a prospective cohort study","volume":"94","author":"Dibaba","year":"2019","journal-title":"Metabolism"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1007\/s00384-006-0259-6","article-title":"Evaluation of an inflammation-based prognostic score (GPS) in patients undergoing resection for colon and rectal cancer","volume":"22","author":"McMillan","year":"2007","journal-title":"Int. J. Color. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1038\/sj.bjc.6602591","article-title":"A prospective longitudinal study of performance status, an inflammation-based score (GPS) and survival in patients with inoperable non-small-cell lung cancer","volume":"92","author":"Forrest","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2889","DOI":"10.1016\/j.clnu.2019.12.024","article-title":"Comparison of the prognostic value of ECOG-PS, mGPS and BMI\/WL: Implications for a clinically important framework in the assessment and treatment of advanced cancer","volume":"39","author":"Dolan","year":"2020","journal-title":"Clin. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1002\/cncr.28018","article-title":"Optimization of the systemic inflammation-based Glasgow prognostic score: A Glasgow Inflammation Outcome Study","volume":"119","author":"Proctor","year":"2013","journal-title":"Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Wu, T.H., Tsai, Y.T., Chen, K.Y., Yap, W.K., and Luan, C.W. (2023). Utility of high-sensitivity modified Glasgow Prognostic Score in cancer prognosis: A systematic review and meta-analysis. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24021318"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1017\/S0029665108007131","article-title":"An inflammation-based prognostic score and its role in the nutrition-based management of patients with cancer","volume":"67","author":"McMillan","year":"2008","journal-title":"Proc. Nutr. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1159\/000362601","article-title":"The high-sensitivity modified Glasgow Prognostic Score is superior to the modified Glasgow Prognostic Score as a prognostic predictor in patients with resectable gastric cancer","volume":"87","author":"Takeno","year":"2014","journal-title":"Oncology"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Ando, K., Sakamoto, S., Saito, S., Maimaiti, M., Imamura, Y., Sazuka, T., Sato, N., Komiya, A., Anzai, N., and Ichikawa, T. (2021). Prognostic value of high-sensitivity modified Glasgow Prognostic Score in castration-resistant prostate cancer patients who received docetaxel. Cancers, 13.","DOI":"10.3390\/cancers13040773"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/0895-4356(96)00025-X","article-title":"Inappropriate use of bivariable analysis to screen risk factors for use in multivariable analysis","volume":"49","author":"Sun","year":"1996","journal-title":"J. Clin. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1093\/oxfordjournals.aje.a115101","article-title":"The impact of confounder selection criteria on effect estimation","volume":"129","author":"Mickey","year":"1989","journal-title":"Am. J. Epidemiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1002\/bimj.201700067","article-title":"Variable selection\u2014A review and recommendations for the practicing statistician","volume":"60","author":"Heinze","year":"2018","journal-title":"Biom. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1002\/wjs.12005","article-title":"Predictors of 1-year mortality after gastrectomy for gastric cancer","volume":"48","author":"Sekimoto","year":"2024","journal-title":"World J. Surg."},{"key":"ref_21","first-page":"e59934","article-title":"Exploring multifactorial relationships: Assessing the correlation between cardiovascular health indicators and metabolic markers","volume":"16","author":"Shende","year":"2024","journal-title":"Cureus"},{"key":"ref_22","unstructured":"GBD 2021 Risk Factors Collaborators (2024). Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990-2021: A systematic analysis for the Global Burden of Disease Study 2021. Lancet, 403, 2162\u20132203."},{"key":"ref_23","first-page":"2725","article-title":"Clinical significance of weight changes at diagnosis in solid tumours","volume":"27","author":"Shrotriya","year":"2019","journal-title":"Support. Care Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1477","DOI":"10.1002\/jcsm.12776","article-title":"Prevalence and prognostic impact of cachexia among older patients with cancer: A nationwide cross-sectional survey (NutriAgeCancer)","volume":"12","author":"Poisson","year":"2021","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1016\/j.cell.2023.03.028","article-title":"Cachexia: A systemic consequence of progressive, unresolved disease","volume":"186","author":"Ferrer","year":"2023","journal-title":"Cell"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Vagnildhaug, O.M., Brunelli, C., Hjermstad, M.J., Strasser, F., Baracos, V., Wilcock, A., Nabal, M., Kaasa, S., Laird, B., and Solheim, T.S. (2019). A prospective study examining cachexia predictors in patients with incurable cancer. BMC Palliat. Care, 18.","DOI":"10.1186\/s12904-019-0429-2"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1016\/j.ejrad.2016.02.005","article-title":"Body composition in clinical practice","volume":"85","author":"Andreoli","year":"2016","journal-title":"Eur. J. Radiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"106050","DOI":"10.1016\/j.appet.2022.106050","article-title":"The gut-brain axis and sodium appetite: Can inflammation-related signaling influence the control of sodium intake?","volume":"175","author":"Freitas","year":"2022","journal-title":"Appetite"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2174\/157339906775473626","article-title":"Chronic inflammation: Role of adipose tissue and modulation by weight loss","volume":"2","author":"You","year":"2006","journal-title":"Curr. Diabetes Rev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Bello, R.O., Chin, V.K., Abd Rachman Isnadi, M.F., Abd Majid, R., Atmadini Abdullah, M., Lee, T.Y., Amiruddin Zakaria, Z., Hussain, M.K., and Basir, R. (2018). The Role, Involvement and Function(s) of Interleukin-35 and Interleukin-37 in Disease Pathogenesis. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19041149"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Cao, J., He, K., Chen, Z., Xu, H., Wei, J., Yan, X., and Song, B. (2025). Interleukin-37 in respiratory diseases: Molecular mechanisms and immune modulation. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1675791"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Su, Z., and Tao, X. (2021). Current Understanding of IL-37 in Human Health and Disease. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.696605"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"155891","DOI":"10.1016\/j.cyto.2022.155891","article-title":"Interleukin-33 (IL-33): A critical review of its biology and the mechanisms involved in its release as a potent extracellular cytokine","volume":"156","author":"Cayrol","year":"2022","journal-title":"Cytokine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1038\/s41586-024-08510-w","article-title":"IL-27 elicits a cytotoxic CD8+ T cell program to enforce tumour control","volume":"639","author":"Williams","year":"2025","journal-title":"Nature"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Riccardi, D., das Neves, R.X., de Matos-Neto, E.M., Camargo, R.G., Lima, J., Radloff, K., Alves, M.J., Costa, R.G.F., Tokeshi, F., and Otoch, J.P. (2020). Plasma lipid profile and systemic inflammation in patients with cancer cachexia. Front. Nutr., 7.","DOI":"10.3389\/fnut.2020.00004"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1016\/j.clnesp.2022.01.021","article-title":"Clinical and nutritional characteristics on overall survival impact in patients with gastrointestinal cancer","volume":"48","author":"Schiessel","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1007\/s00384-020-03568-0","article-title":"A 10-year review of survival among patients with metastatic gastrointestinal cancers: A population-based study","volume":"35","year":"2020","journal-title":"Int. J. Color. Dis."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/17\/2808\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:26:18Z","timestamp":1788236778000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/17\/2808"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,29]]},"references-count":37,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["cancers18172808"],"URL":"https:\/\/doi.org\/10.3390\/cancers18172808","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,29]]}}}