Abstract
Background: Cancer cachexia is characterized as a multi-factorial syndrome, identified by the continuing decline of skeletal muscle mass where nutritional support does not completely reverse the effects. Finding a cure for cachexia will impact cancer patients’ worldwide, improving quality of life and potentially increasing survival in response to standard care. In turn, an accurate diagnostic tool would assist in the identification and translation of therapeutic targets to the clinic. The Glasgow Prognostic Score (GPS), is determined from combining circulating albumin and C-reactive protein (CRP) concentrations to form a score of 0 (normal) and 1 or 2 (abnormal) (albumin < 35g/L=1, and CRP> 10mg/L=1). The GPS has been used as an indicator in various cancer types, due to the presence of systemic inflammation, but not in cancer cachexia. The GPS has been validated in a wide range of clinical situation for a systemic inflammatory response so it may be beneficial in assessing the prognosis of cancer cachexia patients. Method/Design:A retrospective cohort study was conducted to assess the GPS as a valuable tool for diagnosing cancer cachexia. The relationship between BMI and the GPS was examined, along with other parameters for controls and cases. Clinical audit data was collected for 357 participants, 185 cases and 172 controls. Results: The GPS was abnormal (2; with albumin < 35 g/L and CRP > 10mg/L) in 123 (66.5%) cases and in 13 (7.6) controls. The GPS scored was also abnormal (1; with albumin < 35 g/L or CRP > 10 mg/L) in 53 (28.6%) cases and 89 (51.7%) controls. It was normal (0) in 9 (4.9%) cases and in 70 (40.7%) controls. There was a significant correlation between the GPS and a decrease in BMI as P value was 0.019. Conclusion: The GPS could be a useful indicator for the onset of cancer cachexia as advanced cancer is usually associated with a marked systemic inflammatory response which is manifested by an increase in CRP which led to a decrease in albumin. It would be beneficial to investigate if the GPS could be used for early diagnosis of cancer cachexia so it must be included in the basic assessment for all patients with cancer.

Key words: Cancer cachexia, Glasgow Prognostic Score (GPS), C- reactive protein (CRP), Interleukin-6 (IL-6)