| Sign In to gain access to subscriptions and/or personal tools. |
Defining and Classifying Cancer Cachexia: A Proposal by the SCRINIO Working GroupFrom 1 Residenza Le Querce, Milano Due, Segrate, Italy, and 2 Fondazione IRCCS Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy. A list of all contributors to the SCRINIO Study is in the appendix. Address correspondence to: Federico Bozzetti, MD, Residenza Le Querce, Milano Due, 20090 Segrate, Italy; e-mail: dottfb{at}tin.it.
Background: Although cancer cachexia is widely diffuse in the
cancer patient population, there is no objective definition and classification
of this syndrome. The purpose of this study is to propose a simple and quick
classification that relies on the severity of the body weight loss and
presence/absence of symptoms that are associated with cancer cachexia.
Methods: The authors used a database of an ongoing multicenter
prospective investigation on the screening of the nutrition risk of 1307
cancer outpatients from different (mainly Italian) university or scientific
institutes or hospitals. The database included demographic, oncologic,
clinical, and nutrition data. The patients were divided into 4 classes based
on combinations of body weight loss (<10%, precachexia;
Key Words: cachexia classification • cachexia staging • cancer cachexia • weight loss • anorexia • fatigue • early satiation
This version was published on July
1, 2009 Journal of Parenteral and Enteral Nutrition, Vol. 33, No. 4,
361-367 (2009) |
|
||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
 |
|
|
 |
|
Sign In to gain access to subscriptions and/or personal tools.
10%, cachexia)
and the presence/absence of at least 1 symptom of anorexia, fatigue, or early
satiation. The authors verified statistically whether these 4 classes were
associated with the distribution of main clinical, nutrition, and oncologic
variables, after adjustment for treatment status, by using the
Cochrane-Mantel-Hanszel test for count data and ANOVA for continuous data.
Results: Moving from "asymptomatic precachexia" (class 1)
to "symptomatic cachexia" (class 4), there were statistically
significant trends (P < .0001) in the percentage of
gastrointestinal vs nongastrointestinal tumors, severity of cancer stage,
percentage of weight loss, number of symptoms per patient, Eastern Cooperative
Oncology Group (ECOG) performance status, and nutritional risk score.
Conclusions: The statistical analysis has validated the
classification by identifying stages with different severity of cachexia. This
classification could be adopted within a comprehensive oncologic approach to
the weight-losing patients, until more specific diagnostic techniques are
available in clinical practice.