학술논문
Validity of the diagnostic criteria from the Asian Working Group for Cachexia in advanced cancer
Document Type
Report
Author
Source
Journal of Cachexia, Sarcopenia and Muscle. February 2024, Vol. 15 Issue 1, p370, 379 p.
Subject
Language
English
Abstract
Introduction Reduced food intake and abnormal metabolism are the pathophysiological characteristics of cancer cachexia.[sup.1] Ongoing skeletal muscle loss is associated with reduced physical function, tolerance to anticancer therapy and quality [...]
: Background: Recently, the Asian Working Group for Cachexia (AWGC) published a consensus statement on diagnostic criteria for cachexia in Asians. We aimed to validate the criteria in adult patients in Japan with advanced cancer. Methods: We conducted a single‐institution retrospective cohort study between April 2021 and October 2022. The AWGC criteria include chronic comorbidities and either a weight loss of >2% over 3–6 months or a body mass index (BMI) of Results: Of the 449 consecutive patients, 85 of those who could not be evaluated because of end‐of‐life or refractory symptoms (n = 41) or missing data (n = 44) were excluded from the primary analysis. The prevalence of the AWGC‐defined cachexia was 76% (n = 277), and the median survival time (MST) for all patients was 215 (95% confidence interval [CI] 145–270) days. The prevalence of the following criteria was significantly higher in patients with cachexia than in those without cachexia: a BMI of 2% in 6 months (87% vs. 14%, P < 0.001), anorexia (75% vs. 47%, P < 0.001), a grip strength of 5 mg/L (85% vs. 56%, P < 0.001). Overall survival was significantly shorter in patients with cachexia than in those without cachexia (MST 157 days, 95% CI 108–226 days vs. MST 423 days, 95% CI 245 days to not available, P = 0.0023). The Cox proportional hazards analysis showed that best supportive care (hazard ratio [HR] 2.91, P ≤ 0.001), lung cancer (HR 1.67, P = 0.0046), an Eastern Cooperative Oncology Group Performance Status score of ≥3 (HR 1.58, P = 0.016), AWGC‐defined cachexia (HR 1.56, P = 0.015), an age of ≥70 years (HR 1.53, P = 0.0070), oedema (HR 1.31, P = 0.022) and head/neck cancer (HR 0.44, P = 0.023) were found to be the significant predictors for mortality. Conclusions: We demonstrated that AWGC‐defined cachexia has a significant prognostic value in advanced cancer.
: Background: Recently, the Asian Working Group for Cachexia (AWGC) published a consensus statement on diagnostic criteria for cachexia in Asians. We aimed to validate the criteria in adult patients in Japan with advanced cancer. Methods: We conducted a single‐institution retrospective cohort study between April 2021 and October 2022. The AWGC criteria include chronic comorbidities and either a weight loss of >2% over 3–6 months or a body mass index (BMI) of Results: Of the 449 consecutive patients, 85 of those who could not be evaluated because of end‐of‐life or refractory symptoms (n = 41) or missing data (n = 44) were excluded from the primary analysis. The prevalence of the AWGC‐defined cachexia was 76% (n = 277), and the median survival time (MST) for all patients was 215 (95% confidence interval [CI] 145–270) days. The prevalence of the following criteria was significantly higher in patients with cachexia than in those without cachexia: a BMI of 2% in 6 months (87% vs. 14%, P < 0.001), anorexia (75% vs. 47%, P < 0.001), a grip strength of 5 mg/L (85% vs. 56%, P < 0.001). Overall survival was significantly shorter in patients with cachexia than in those without cachexia (MST 157 days, 95% CI 108–226 days vs. MST 423 days, 95% CI 245 days to not available, P = 0.0023). The Cox proportional hazards analysis showed that best supportive care (hazard ratio [HR] 2.91, P ≤ 0.001), lung cancer (HR 1.67, P = 0.0046), an Eastern Cooperative Oncology Group Performance Status score of ≥3 (HR 1.58, P = 0.016), AWGC‐defined cachexia (HR 1.56, P = 0.015), an age of ≥70 years (HR 1.53, P = 0.0070), oedema (HR 1.31, P = 0.022) and head/neck cancer (HR 0.44, P = 0.023) were found to be the significant predictors for mortality. Conclusions: We demonstrated that AWGC‐defined cachexia has a significant prognostic value in advanced cancer.