Validation of the Consensus-Definition for Cancer Cachexia and evaluation of a classification model-a study based on data from an international multicentre project (EPCRC-CSA)

被引:195
作者
Blum, D. [1 ,2 ]
Stene, G. B. [1 ,2 ,3 ]
Solheim, T. S. [1 ,2 ]
Fayers, P. [1 ,4 ]
Hjermstad, M. J. [1 ,5 ]
Baracos, V. E. [6 ]
Fearon, K. [7 ]
Strasser, F. [1 ,8 ,9 ]
Kaasa, S. [1 ,2 ]
机构
[1] Norwegian Univ Sci & Technol NTNU, Fac Med, European Palliat Care Res Ctr, Trondheim, Norway
[2] Univ Trondheim Hosp, St Olavs Hosp, Canc Clin, Trondheim, Norway
[3] Norwegian Univ Sci & Technol NTNU, Fac Med, Dept Neurosci, Trondheim, Norway
[4] Univ Aberdeen, Inst Appl Hlth Sci, Aberdeen, Scotland
[5] Oslo Univ Hosp, Reg Ctr Excellence Palliat Care, Dept Oncol, Oslo, Norway
[6] Univ Alberta, Div Palliat Care Med, Dept Oncol, Edmonton, AB T6G 2M7, Canada
[7] Univ Edinburgh, Royal Infirm, Edinburgh EH3 9YW, Midlothian, Scotland
[8] Cantonal Hosp, Dept Internal Med, St Gallen, Switzerland
[9] Cantonal Hosp, Palliat Ctr, St Gallen, Switzerland
关键词
cancer; cachexia; classification; validation; SYMPTOM ASSESSMENT; WEIGHT-LOSS; NEED;
D O I
10.1093/annonc/mdu086
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Weight loss limits cancer therapy, quality of life and survival. Common diagnostic criteria and a framework for a classification system for cancer cachexia were recently agreed upon by international consensus. Specific assessment domains (stores, intake, catabolism and function) were proposed. The aim of this study is to validate this diagnostic criteria (two groups: model 1) and examine a four-group (model 2) classification system regarding these domains as well as survival. Patients and methods: Data from an international patient sample with advanced cancer (N = 1070) were analysed. In model 1, the diagnostic criteria for cancer cachexia [weight loss/body mass index (BMI)] were used. Model 2 classified patients into four groups 0-III, according to weight loss/BMI as a framework for cachexia stages. The cachexia domains, survival and sociodemographic/medical variables were compared across models. Results: Eight hundred and sixty-one patients were included. Model 1 consisted of 399 cachectic and 462 non-cachectic patients. Cachectic patients had significantly higher levels of inflammation, lower nutritional intake and performance status and shorter survival. In model 2, differences were not consistent; appetite loss did not differ between group III and IV, and performance status not between group 0 and I. Survival was shorter in group II and III compared with other groups. By adding other cachexia domains to the model, survival differences were demonstrated. Conclusion: The diagnostic criteria based on weight loss and BMI distinguish between cachectic and non-cachectic patients concerning all domains (intake, catabolism and function) and is associated with survival. In order to guide cachexia treatment a four-group classification model needs additional domains to discriminate between cachexia stages.
引用
收藏
页码:1635 / 1642
页数:9
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