Prognostic factors in advanced gastrointestinal cancer patients with weight loss

There are few reports on factors that determine survival in advanced gastro intestinal cancer with weight loss. In these patients (n = 91, median weigh t loss 16.6%), we prospectively examined the importance of metastatic sprea d, anthropometry, blood parameters, Karnofsky performance status, appetite, and the acute-phase response as predictors of survival. Survival was calcu lated from date of assessment to the most recent clinic attendance (greater than or equal to 30 mo) or until death. On multivariate analysis, metastat ic spread (p < 0.05), Karnofsky performance status (p < 0.01), and C-reacti ve protein concentration (p < 0.001) had independent prognostic value. In l ocally advanced disease (n = 64), Karnofsky performance status and C-reacti ve protein concentration remained significant. There was a significantly lo wer survival in patients with an acute-phase response (median 136 days) tha n in patients with no response (median 466 days; p < 0.01). Performance sta tus and the acute-phase response are associated, independent of weight loss , with survival duration in advanced gastrointestinal cancer patients.