Integrating Systemic Inflammation and Longitudinal Weight Trajectories Improves Prognostic Stratification in Gastrointestinal Cancers: A Real-World Retrospective Study

Abstract

Simple Summary This retrospective study of 176 patients with gastrointestinal cancers evaluated whether integrating systemic inflammation and longitudinal weight change improves prognostic stratification. The high-sensitivity modified Glasgow Prognostic Score (hs-mGPS), derived from baseline albumin and hs-CRP, and daily weight change by percentile (DWtCP), derived from serial weights, were examined overall and across BMI categories. Nearly 70% of patients had hs-mGPS = 2, which was associated with poorer survival, most clearly in the earlier part of follow-up and among high-BMI patients. DWtCP was strongly associated with survival; patients with moderate weight loss had the most favorable 1200-day survival, outperforming both severe weight loss and weight gain groups. In multivariable and BMI-stratified models, DWtCP and primary cancer site were independent predictors of mortality, whereas albumin and hs-CRP contributed through the composite hs-mGPS score rather than individually. These findings suggest that routine monitoring of hs-mGPS and weight trajectories using electronic health record data may enable pragmatic risk stratification in GI cancers, especially in patients with higher BMI.