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01-06-2013 | Original Article

Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients

Published in: Supportive Care in Cancer | Issue 6/2013

Abstract

Purpose

Cachexia is associated with adverse outcomes. There is limited information on the impact of different diagnostic criteria of cachexia on patient centered outcomes.

Methods

We compared the prevalence of reduced quality of life (QoL), physical function and survival in palliative care cancer patients classified by different cachexia criteria. Four hundred and five patients with advanced cancer were included. Cachexia criteria were BMI, weight loss, fatigue, Karnofsky performance score, low handgrip strength, lean tissue depletion (DXA or arm muscle circumference) and abnormal biochemistry (inflammation, anemia or low serum albumin). QoL was assessed with a cancer specific questionnaire (EORTC QLQ-C30) and classified by cluster analysis. Dietary intake was obtained from a 4-day food record. Physical function was measured on a treadmill.

Results

Weight loss >2 %, BMI <20, fatigue and CRP >10 mg/L were associated with adverse QoL, function and symptoms (odds ratios: 2.1, 2.9, 4.0 and 3.1 respectively, P < 0.05 for all). Fatigue, low grip strength and markers of systemic inflammation were associated with short walking distance (P < 0.05). Weight loss > 2 %, fatigue, CRP > 10 mg/L and S-albumin < 32 g/L were associated with shorter survival (hazard ratios: 1.4, 1.6, 2.2 and 2.0 respectively, P < 0.05 for all). The prevalence of cachexia diagnosis varied from 12 to 85 % using different definitions.

Conclusions

Weight loss, fatigue and markers of systemic inflammation were most strongly and consistently associated with adverse QoL, reduced functional abilities, more symptoms and shorter survival. The prevalence of cachexia using different definitions varied widely; indicating a need to further explore and validate diagnostic criteria for cancer cachexia.

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Title: Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients
Publication date: 01-06-2013
Published in: Supportive Care in Cancer / Issue 6/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-012-1697-z

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