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)

D Blum (Corresponding Author), G. B. Stene, T.S. Solheim, P. Fayers, M. J. Hjermstad, V.E. Baracos, K. Fearon, F Strasser, S. Kaasa, Euro-Impact

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

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.
Original languageEnglish
Pages (from-to)1635-1642
Number of pages8
JournalAnnals of Oncology
Volume25
Issue number8
Early online date20 Feb 2014
DOIs
Publication statusPublished - 1 Aug 2014

Fingerprint

Cachexia
Consensus
Survival
Neoplasms
Weight Loss
Body Mass Index
Appetite
Quality of Life
Inflammation
Therapeutics

Keywords

  • Cancer
  • Cachexia
  • Classification
  • Validation

Cite this

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). / Blum, D (Corresponding Author); Stene, G. B.; Solheim, T.S.; Fayers, P.; Hjermstad, M. J.; Baracos, V.E.; Fearon, K.; Strasser, F; Kaasa, S.; Euro-Impact.

In: Annals of Oncology, Vol. 25, No. 8, 01.08.2014, p. 1635-1642.

Research output: Contribution to journalArticle

Blum, D ; Stene, G. B. ; Solheim, T.S. ; Fayers, P. ; Hjermstad, M. J. ; Baracos, V.E. ; Fearon, K. ; Strasser, F ; Kaasa, S. ; Euro-Impact. / 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). In: Annals of Oncology. 2014 ; Vol. 25, No. 8. pp. 1635-1642.
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title = "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)",
abstract = "BackgroundWeight 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 methodsData 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.ResultsEight 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.ConclusionThe 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.",
keywords = "Cancer, Cachexia, Classification, Validation",
author = "D Blum and Stene, {G. B.} and T.S. Solheim and P. Fayers and Hjermstad, {M. J.} and V.E. Baracos and K. Fearon and F Strasser and S. Kaasa and Euro-Impact",
note = "Acknowledgements We would like to thank all people involved in the European Palliative Care Research Collaborative (EPCRC) and EURO IMPACT, European Intersectorial and Multidisciplinary Palliative Care Research Training. Funding EPCRC was funded by the European Union’s 6th 274 Support Care Cancer (2010) 18:273–279 framework in 2006 EURO IMPACT is funded by the European Union Seventh Framework Programme (FP7/2007–2013, under grant agreement no [264697]).",
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TY - JOUR

T1 - Validation of the Consensus-Definition for Cancer Cachexia and evaluation of a classification model

T2 - A study based on data from an international multicentre project (EPCRC-CSA)

AU - Blum, D

AU - Stene, G. B.

AU - Solheim, T.S.

AU - Fayers, P.

AU - Hjermstad, M. J.

AU - Baracos, V.E.

AU - Fearon, K.

AU - Strasser, F

AU - Kaasa, S.

AU - Euro-Impact

N1 - Acknowledgements We would like to thank all people involved in the European Palliative Care Research Collaborative (EPCRC) and EURO IMPACT, European Intersectorial and Multidisciplinary Palliative Care Research Training. Funding EPCRC was funded by the European Union’s 6th 274 Support Care Cancer (2010) 18:273–279 framework in 2006 EURO IMPACT is funded by the European Union Seventh Framework Programme (FP7/2007–2013, under grant agreement no [264697]).

PY - 2014/8/1

Y1 - 2014/8/1

N2 - BackgroundWeight 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 methodsData 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.ResultsEight 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.ConclusionThe 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.

AB - BackgroundWeight 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 methodsData 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.ResultsEight 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.ConclusionThe 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.

KW - Cancer

KW - Cachexia

KW - Classification

KW - Validation

U2 - 10.1093/annonc/mdu086

DO - 10.1093/annonc/mdu086

M3 - Article

VL - 25

SP - 1635

EP - 1642

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 8

ER -