Skip to main content
Top
Published in:

Open Access 01-10-2024 | Underweight | Research

Machine learning to identify precachexia and cachexia: a multicenter, retrospective cohort study

Authors: Yue Chen, Chenan Liu, Xin Zheng, Tong Liu, Hailun Xie, Shi-qi Lin, Heyang Zhang, Jinyu Shi, Xiaoyue Liu, Ziwen Wang, Li Deng, Hanping Shi

Published in: Supportive Care in Cancer | Issue 10/2024

Login to get access

Abstract

Background

Detection of precachexia is important for the prevention and treatment of cachexia. However, how to identify precachexia is still a challenge.

Objective

This study aimed to detect cancer precachexia using a simple method and distinguish the different characteristics of precachexia and cachexia.

Methods

We included 3896 participants in this study. We used all baseline characteristics as input variables and trained machine learning (ML) models to calculate the importance of the variables. After filtering the variables based on their importance, the models were retrained. The best model was selected based on the receiver operating characteristic value. Subsequently, we used the same method and process to identify patients with precachexia in a noncachexia population using the same method and process.

Results

Participants in this study included 2228 men (57.2%) and 1668 women (42.8%), of whom 471 were diagnosed with precachexia, 1178 with cachexia, and the remainder with noncachexia. The most important characteristics of cachexia were eating changes, arm circumference, high-density lipoprotein (HDL) level, and C-reactive protein albumin ratio (CAR). The most important features distinguishing precachexia were eating changes, serum creatinine, HDL, handgrip strength, and CAR. The two logistic regression models for screening for cachexia and diagnosing precachexia had the highest area under the curve values of 0.830 and 0.701, respectively. Calibration and decision curves showed that the models had good accuracy.

Conclusion

We developed two models for identifying precachexia and cachexia, which will help clinicians detect and diagnose precachexia.
Appendix
Available only for authorised users
Literature
1.
go back to reference Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH (2018) Cancer-associated cachexia. Nat Rev Dis Primers 4:17105CrossRefPubMed Baracos VE, Martin L, Korc M, Guttridge DC, Fearon KCH (2018) Cancer-associated cachexia. Nat Rev Dis Primers 4:17105CrossRefPubMed
2.
go back to reference Fearon K, Arends J, Baracos V (2013) Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol 10(2):90–99CrossRefPubMed Fearon K, Arends J, Baracos V (2013) Understanding the mechanisms and treatment options in cancer cachexia. Nat Rev Clin Oncol 10(2):90–99CrossRefPubMed
3.
go back to reference Argilés JM, Busquets S, Stemmler B, López-Soriano FJ (2014) Cancer cachexia: understanding the molecular basis. Nat Rev Cancer 14(11):754–762CrossRefPubMed Argilés JM, Busquets S, Stemmler B, López-Soriano FJ (2014) Cancer cachexia: understanding the molecular basis. Nat Rev Cancer 14(11):754–762CrossRefPubMed
5.
go back to reference Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM, Biolo G et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics.” Clin Nutr 29(2):154–159CrossRefPubMed Muscaritoli M, Anker SD, Argilés J, Aversa Z, Bauer JM, Biolo G et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics.” Clin Nutr 29(2):154–159CrossRefPubMed
6.
go back to reference Cui J, Liu Y, Li F, Zhuo W, Huang L, Xu C et al (2023) Evidence-based guideline on immunonutrition in patients with cancer. Precis Nutr 2(1):e00031 Cui J, Liu Y, Li F, Zhuo W, Huang L, Xu C et al (2023) Evidence-based guideline on immunonutrition in patients with cancer. Precis Nutr 2(1):e00031
7.
go back to reference Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL et al (2011) Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 12(5):489–495CrossRefPubMed
8.
go back to reference Roeland EJ (2022) Cancer cachexia: the elephant in the room? J Cachexia Sarcopenia Muscle 13(1):3–4CrossRefPubMed Roeland EJ (2022) Cancer cachexia: the elephant in the room? J Cachexia Sarcopenia Muscle 13(1):3–4CrossRefPubMed
9.
go back to reference Greener JG, Kandathil SM, Moffat L, Jones DT (2022) A guide to machine learning for biologists. Nat Rev Mol Cell Biol 23(1):40–55CrossRefPubMed Greener JG, Kandathil SM, Moffat L, Jones DT (2022) A guide to machine learning for biologists. Nat Rev Mol Cell Biol 23(1):40–55CrossRefPubMed
11.
go back to reference Xu H, Song C, Yin L, Wang C, Fu Z, Guo Z et al (2022) Extension protocol for the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China (INSCOC) study: 2021 update. Precis Nutr 1(2):e00014 Xu H, Song C, Yin L, Wang C, Fu Z, Guo Z et al (2022) Extension protocol for the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China (INSCOC) study: 2021 update. Precis Nutr 1(2):e00014
12.
go back to reference Baracos VE, Coats AJ, Anker SD, Sherman L, Klompenhouwer T (2022) Identification and management of cancer cachexia in patients: assessment of healthcare providers’ knowledge and practice gaps. J Cachexia Sarcopenia Muscle 13(6):2683–2696CrossRefPubMedPubMedCentral Baracos VE, Coats AJ, Anker SD, Sherman L, Klompenhouwer T (2022) Identification and management of cancer cachexia in patients: assessment of healthcare providers’ knowledge and practice gaps. J Cachexia Sarcopenia Muscle 13(6):2683–2696CrossRefPubMedPubMedCentral
13.
go back to reference Yin L, Cui J, Lin X, Li N, Fan Y, Zhang L et al (2022) Identifying cancer cachexia in patients without weight loss information: machine learning approaches to address a real-world challenge. Am J Clin Nutr 116:1229CrossRefPubMed Yin L, Cui J, Lin X, Li N, Fan Y, Zhang L et al (2022) Identifying cancer cachexia in patients without weight loss information: machine learning approaches to address a real-world challenge. Am J Clin Nutr 116:1229CrossRefPubMed
14.
go back to reference O’Connell TM, Golzarri-Arroyo L, Pin F, Barreto R, Dickinson SL, Couch ME et al (2021) Metabolic biomarkers for the early detection of cancer cachexia. Front Cell Dev Biol 9:720096CrossRefPubMedPubMedCentral O’Connell TM, Golzarri-Arroyo L, Pin F, Barreto R, Dickinson SL, Couch ME et al (2021) Metabolic biomarkers for the early detection of cancer cachexia. Front Cell Dev Biol 9:720096CrossRefPubMedPubMedCentral
15.
go back to reference Muscaritoli M, Aversa Z, Lucia S (2014) The conundrum of pre-cachexia existence. Clin Nutr 33(6):1160CrossRefPubMed Muscaritoli M, Aversa Z, Lucia S (2014) The conundrum of pre-cachexia existence. Clin Nutr 33(6):1160CrossRefPubMed
16.
go back to reference Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S (1983) Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 37(3):478–494CrossRefPubMed Heymsfield SB, Arteaga C, McManus C, Smith J, Moffitt S (1983) Measurement of muscle mass in humans: validity of the 24-hour urinary creatinine method. Am J Clin Nutr 37(3):478–494CrossRefPubMed
17.
go back to reference Delgado C, Johansen KL (2020) Revisiting serum creatinine as an indicator of muscle mass and a predictor of mortality among patients on hemodialysis. Nephrol Dial Transplant 35(12):2033–2035CrossRefPubMedPubMedCentral Delgado C, Johansen KL (2020) Revisiting serum creatinine as an indicator of muscle mass and a predictor of mortality among patients on hemodialysis. Nephrol Dial Transplant 35(12):2033–2035CrossRefPubMedPubMedCentral
18.
go back to reference Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM et al (2008) Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol 3(2):348–354CrossRefPubMedPubMedCentral Baxmann AC, Ahmed MS, Marques NC, Menon VB, Pereira AB, Kirsztajn GM et al (2008) Influence of muscle mass and physical activity on serum and urinary creatinine and serum cystatin C. Clin J Am Soc Nephrol 3(2):348–354CrossRefPubMedPubMedCentral
19.
go back to reference Tang T, Xie L, Hu S, Tan L, Lei X, Luo X et al (2022) Serum creatinine and cystatin C-based diagnostic indices for sarcopenia in advanced non-small cell lung cancer. J Cachexia Sarcopenia Muscle 13(3):1800–1810CrossRefPubMedPubMedCentral Tang T, Xie L, Hu S, Tan L, Lei X, Luo X et al (2022) Serum creatinine and cystatin C-based diagnostic indices for sarcopenia in advanced non-small cell lung cancer. J Cachexia Sarcopenia Muscle 13(3):1800–1810CrossRefPubMedPubMedCentral
20.
go back to reference Song M, Zhang Q, Tang M, Zhang X, Ruan G, Zhang X et al (2021) Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study. J Cachexia Sarcopenia Muscle 12(6):1489–1500CrossRefPubMedPubMedCentral Song M, Zhang Q, Tang M, Zhang X, Ruan G, Zhang X et al (2021) Associations of low hand grip strength with 1 year mortality of cancer cachexia: a multicentre observational study. J Cachexia Sarcopenia Muscle 12(6):1489–1500CrossRefPubMedPubMedCentral
21.
go back to reference Op den Kamp CM, Langen RC, Minnaard R, Kelders MC, Snepvangers FJ, Hesselink MK et al (2012) Pre-cachexia in patients with stages I-III non-small cell lung cancer: systemic inflammation and functional impairment without activation of skeletal muscle ubiquitin proteasome system. Lung Cancer 76(1):112–7CrossRefPubMed Op den Kamp CM, Langen RC, Minnaard R, Kelders MC, Snepvangers FJ, Hesselink MK et al (2012) Pre-cachexia in patients with stages I-III non-small cell lung cancer: systemic inflammation and functional impairment without activation of skeletal muscle ubiquitin proteasome system. Lung Cancer 76(1):112–7CrossRefPubMed
22.
go back to reference Narasimhan A, Shahda S, Kays JK, Perkins SM, Cheng L, Schloss KNH et al (2020) Identification of potential serum protein biomarkers and pathways for pancreatic cancer cachexia using an aptamer-based discovery platform. Cancers (Basel) 12(12):3787CrossRefPubMedPubMedCentral Narasimhan A, Shahda S, Kays JK, Perkins SM, Cheng L, Schloss KNH et al (2020) Identification of potential serum protein biomarkers and pathways for pancreatic cancer cachexia using an aptamer-based discovery platform. Cancers (Basel) 12(12):3787CrossRefPubMedPubMedCentral
23.
go back to reference Poulia KA, Sarantis P, Antoniadou D, Koustas E, Papadimitropoulou A, Papavassiliou AG et al (2020) Pancreatic cancer and cachexia-metabolic mechanisms and novel insights. Nutrients 12(6):1543CrossRefPubMedPubMedCentral Poulia KA, Sarantis P, Antoniadou D, Koustas E, Papadimitropoulou A, Papavassiliou AG et al (2020) Pancreatic cancer and cachexia-metabolic mechanisms and novel insights. Nutrients 12(6):1543CrossRefPubMedPubMedCentral
24.
go back to reference Zhang Q, Song M-M, Zhang X, Ding J-S, Ruan G-T, Zhang X-W et al (2021) Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study. J Cachexia Sarcopenia Muscle 12(6):1466–1476CrossRefPubMedPubMedCentral Zhang Q, Song M-M, Zhang X, Ding J-S, Ruan G-T, Zhang X-W et al (2021) Association of systemic inflammation with survival in patients with cancer cachexia: results from a multicentre cohort study. J Cachexia Sarcopenia Muscle 12(6):1466–1476CrossRefPubMedPubMedCentral
26.
go back to reference Giacosa A, Frascio F, Sukkar SG, Roncella S (1996) Food intake and body composition in cancer cachexia. Nutrition 12(1 Suppl):S20–S23CrossRefPubMed Giacosa A, Frascio F, Sukkar SG, Roncella S (1996) Food intake and body composition in cancer cachexia. Nutrition 12(1 Suppl):S20–S23CrossRefPubMed
27.
go back to reference Martin L, Muscaritoli M, Bourdel-Marchasson I, Kubrak C, Laird B, Gagnon B et al (2021) Diagnostic criteria for cancer cachexia: reduced food intake and inflammation predict weight loss and survival in an international, multi-cohort analysis. J Cachexia Sarcopenia Muscle 12(5):1189–1202CrossRefPubMedPubMedCentral Martin L, Muscaritoli M, Bourdel-Marchasson I, Kubrak C, Laird B, Gagnon B et al (2021) Diagnostic criteria for cancer cachexia: reduced food intake and inflammation predict weight loss and survival in an international, multi-cohort analysis. J Cachexia Sarcopenia Muscle 12(5):1189–1202CrossRefPubMedPubMedCentral
28.
go back to reference Archid R, Solass W, Tempfer C, Königsrainer A, Adolph M, Reymond MA et al (2019) Cachexia anorexia syndrome and associated metabolic dysfunction in peritoneal metastasis. Int J Mol Sci 20(21):5444CrossRefPubMedPubMedCentral Archid R, Solass W, Tempfer C, Königsrainer A, Adolph M, Reymond MA et al (2019) Cachexia anorexia syndrome and associated metabolic dysfunction in peritoneal metastasis. Int J Mol Sci 20(21):5444CrossRefPubMedPubMedCentral
29.
go back to reference Peixoto da Silva S, Santos JMO, Costa e Silva MP, da Gil RMC, Medeiros R (2020) Cancer cachexia and its pathophysiology: links with sarcopenia, anorexia and asthenia. J Cachexia Sarcopenia Muscle 11(3):619–35CrossRefPubMedPubMedCentral Peixoto da Silva S, Santos JMO, Costa e Silva MP, da Gil RMC, Medeiros R (2020) Cancer cachexia and its pathophysiology: links with sarcopenia, anorexia and asthenia. J Cachexia Sarcopenia Muscle 11(3):619–35CrossRefPubMedPubMedCentral
31.
go back to reference Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(4):601CrossRefPubMedPubMedCentral Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T et al (2019) Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing 48(4):601CrossRefPubMedPubMedCentral
32.
33.
go back to reference Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P et al (2021) Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines☆. ESMO Open 6(3):100092CrossRefPubMedPubMedCentral Arends J, Strasser F, Gonella S, Solheim TS, Madeddu C, Ravasco P et al (2021) Cancer cachexia in adult patients: ESMO Clinical Practice Guidelines☆. ESMO Open 6(3):100092CrossRefPubMedPubMedCentral
Metadata
Title
Machine learning to identify precachexia and cachexia: a multicenter, retrospective cohort study
Authors
Yue Chen
Chenan Liu
Xin Zheng
Tong Liu
Hailun Xie
Shi-qi Lin
Heyang Zhang
Jinyu Shi
Xiaoyue Liu
Ziwen Wang
Li Deng
Hanping Shi
Publication date
01-10-2024
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 10/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-024-08833-4

Other articles of this Issue 10/2024

Supportive Care in Cancer 10/2024 Go to the issue

2024 ESMO Congress

Recent advances in the use of CAR T-cell therapies in relapsed/refractory diffuse large B-cell lymphoma and follicular lymphoma

  • Webinar | 01-10-2024 | 12:30 (CEST)

Live event concluded

In this webinar, Professor Martin Dreyling and an esteemed, international panel of CAR-T experts discuss the latest data on the safety, efficacy, and clinical impact of CAR T-cell therapies in the treatment of r/r DLBCL and r/r FL.

Please note, this webinar is not intended for healthcare professionals based in the US and UK.

Sponsored by: Novartis Pharma AG

Chaired by: Prof. Martin Dreyling
Developed by: Springer Healthcare
Get a reminder for the on-demand version