Cachexia in cancer: what is in the definition?

Autor:	Vanhoutte G; Universitair Ziekenhuis Antwerpen (UZA) Wilrijkstraat , Edegem , Belgium., van de Wiel M; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium., Wouters K; Scientific Coordination and Biostatistics , University Hospital Antwerp (UZA) , Edegem , Belgium., Sels M; Department of Dietetics , University Hospital Antwerp (UZA) Oncology (MOCA) , Edegem , Belgium., Bartolomeeussen L; Department of Dietetics , University Hospital Antwerp (UZA) Oncology (MOCA) , Edegem , Belgium., De Keersmaecker S; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium., Verschueren C; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium., De Vroey V; Department of Clinical Biology , University Hospital Antwerp (UZA) , Edegem , Belgium., De Wilde A; Department of Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium., Smits E; Scientific Coordination and Biostatistics , University Hospital Antwerp (UZA) , Edegem , Belgium., Cheung KJ; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium., De Clerck L; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium., Aerts P; Laboratory of Experimental Medicine and Pediatrics (LEMP) , University of Antwerp (UA) , Wilrijk , Belgium., Baert D; Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium., Vandoninck C; Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium., Kindt S; Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium., Schelfhaut S; Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium., Vankerkhoven M; Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium., Troch A; Heilig Hart Hospital , Lier , Belgium., Ceulemans L; Heilig Hart Hospital , Lier , Belgium., Vandenbergh H; Heilig Hart Hospital , Lier , Belgium., Leys S; Heilig Hart Hospital , Lier , Belgium., Rondou T; Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium., Dewitte E; Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium., Maes K; Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium., Pauwels P; Department of Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium., De Winter B; Laboratory of Experimental Medicine and Pediatrics (LEMP) , University of Antwerp (UA) , Wilrijk , Belgium., Van Gaal L; Endocrinology, Diabetology, Metabolic Diseases and Nutrition Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium., Ysebaert D; Hepatobiliary Surgery University Hospital Antwerp (UZA), Edegem, Belgium., Peeters M; Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
Jazyk:	angličtina
Zdroj:	BMJ open gastroenterology [BMJ Open Gastroenterol] 2016 Oct 18; Vol. 3 (1), pp. e000097. Date of Electronic Publication: 2016 Oct 18 (Print Publication: 2016).
DOI:	10.1136/bmjgast-2016-000097
Abstrakt:	Objective: This study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia. Design: Data collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearon et al 's definition is based on weight loss, body mass index (BMI) and sarcopenia. Evans et al nuances the contribution of sarcopenia and attaches additional attention to abnormal biochemistry parameters, fatigue and anorexia. The mean OS rates were compared between patients with and without cachexia for both definitions. Results: Based on the population of 167 patients who enrolled, 70% developed cachexia according to Fearon et al 's definition and 40% according to Evans et al 's definition. The OS in the cachectic population is 0.97 and 0.55 years, respectively. The difference in OS between patients with and without cachexia is more significant using the diagnostic criteria of Evans et al . The focus of Fearon et al on weight loss and sarcopenia over-rates the assignment of patients to the cachectic group and OS rates have less prognostic value. Conclusion: This study presents a correlation with prognosis in favour of Evans et al ' definition as a tool for cachexia diagnosis. This means that weight loss and BMI decline are both key factors in patients with cancer leading to cachexia but less decisive as stated by Fearon et al . Instead, extra factors gain importance in order to predict survival, such as chronic inflammation, anaemia, protein depletion, reduced food intake, fatigue, decreased muscle strength and lean tissue depletion. Trial Registration Number: B300201112334. Competing Interests: Conflicts of Interest: None declared.
Databáze:	MEDLINE
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