Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients.

Détails

ID Serval
serval:BIB_1CE0FE30A23C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients.
Périodique
Clinical nutrition
Auteur(s)
Vigano AAL, Morais J.A., Ciutto L., Rosenthall L., di Tomasso J., Khan S., Olders H., Borod M., Kilgour R.D.
ISSN
1532-1983 (Electronic)
ISSN-L
0261-5614
Statut éditorial
Publié
Date de publication
10/2017
Peer-reviewed
Oui
Volume
36
Numéro
5
Pages
1378-1390
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Cachexia is a highly prevalent syndrome in cancer and chronic diseases. However, due to the heterogeneous features of cancer cachexia, its identification and classification challenge clinical practitioners.
To determine the clinical relevance of a cancer cachexia classification system in advanced cancer patients.
Beginning with the four-stage classification system proposed for cachexia [non-cachexia (NCa), pre-cachexia (PCa), cachexia (Ca) and refractory cachexia (RCa)], we assigned patients to these cachexia stages according to five classification criteria available in clinical practice: 1) biochemistry (high C-reactive protein or leukocytes, or hypoalbuminemia, or anemia), 2) food intake (normal/decreased), weight loss: 3) moderate (≤5%) or 4) significant (>5%/past six months) and 5) performance status (Eastern Cooperative Oncology Group Performance Status ≥ 3). We then determined if symptom severity, body composition changes, functional levels, hospitalizations and survival rates varied significantly across cachexia stages.
Two-hundred and ninety-seven advanced cancer patients with primary gastrointestinal and lung tumors were included. Patients were classified into Ca (36%), PCa and RCa (21%, respectively) and NCa (15%). Significant (p < 0.05) differences were observed among cachexia stages for most of the outcome measures (symptoms, body composition, handgrip strength, emergency room visits and length of hospital stays) according to cachexia severity. Survival also differed between cachexia stages (except between PCa and Ca).
Five clinical criteria can be used to stage cancer cachexia patients and predict important clinical, nutritional and functional outcomes. The lack of statistical difference between PCa and Ca in almost all clinical outcomes examined suggests either that the PCa group includes patients already affected by early cachexia or that more precise criteria are needed to differentiate PCa from Ca patients. More studies are required to validate these findings.
Mots-clé
Aged, Anemia, Iron-Deficiency/diagnosis, Anemia, Iron-Deficiency/etiology, Body Composition, C-Reactive Protein/metabolism, Cachexia/diagnosis, Cachexia/etiology, Cross-Sectional Studies, Diet, Female, Follow-Up Studies, Hand Strength, Humans, Hypoalbuminemia/diagnosis, Hypoalbuminemia/etiology, Leukocytes/cytology, Male, Middle Aged, Neoplasms/complications, Neoplasms/therapy, Retrospective Studies, Weight Loss, Body composition, Cachexia, Cancer, Classification, Survival
Pubmed
Web of science
Création de la notice
30/11/2016 18:34
Dernière modification de la notice
24/05/2018 19:20
Données d'usage