1544O - Comparison of nutritional assessment with a new definition of cachexia in determining outcomes of advanced cancer patients

Date 01 October 2012
Event ESMO Congress 2012
Session Supportive and palliative care
Topics Supportive Care
Presenter Stephen Clarke
Authors S. Clarke1, C. Tan2, J. Read3, V. Phan4, J.K. Peat5, P. Beale4
  • 1Medical Oncology, Royal North Shore Hospital,, 2065 - Sydney/AU
  • 2Nutrition And Dietetics Department, Concord Hospital, 2139 - Sydney/AU
  • 3Prince Of Wales Hospital, Prince of Wales Hospital, 2139 - Sydney/AU
  • 4Medical Oncology Department, Concord Hospital, Sydney Cancer Center Concord Hospital, 2139 - Sydney/AU
  • 5Consultant Biostatician, Concord Hospital, 2139 - Sydney/AU

Abstract

Background

An international consensus statement providing a definition and diagnostic criteria for cancer cachexia was recently published. This study aimed to compare the relative prognostic utility of this definition with nutritional status as defined by the Patient-Generated Subjective Global Assessment (PG-SGA) tool.

Methods

A prospective cohort study was conducted in a tertiary hospital where chemotherapy naive patients with life expectancy ≥3 months were recruited by medical oncologists and a research dietitian. Kaplan-Meier survival analyses were used to determine the median survival of patients with advanced cancer in the cohort study, and a subset of patients who met the criteria for cancer cachexia as defined in the international consensus (Fearon 2011). The log rank chi-square test was used to evaluate the strength of predictors of overall survival (OS). A P value of <0.05 was considered significant.

Results

The following table demonstrates the patient baseline characteristics of the two cohorts.

Cachexia (Met ≥1 criteria) Malnourished (PG-SGA B/C)
Sample size 80% (n= 62/78) 58% (n= 66/114)
Age, years, mean 61 (SD 8.7) 63 (SD 9.7)
Male, % (n) 63% (39) 67% (44)
% of weight loss in 6 months preceding, mean 11.1 (SD 5.5) 9.5 (SD 6.4)
Estimated OS, mths, median (95% CI) Log rank test (Mantel-Cox) 11.4 (5.5 – 17.3) 2.24 8.4 (4.06 – 12.69) 8.07

Sixty eight percent of the advanced cancer patients (53 of the 78) were both malnourished and met ≥1 of the proposed diagnostic criteria for cachexia at baseline. The log rank test from the Kaplan-Meier survival analysis demonstrated that nutritional status as defined by PG-SGA tool was a stronger overall predictor of OS than the recently defined criteria.

Conclusions

The concept of using the PG-SGA tool to identify potential patients with cachexia for future trials deserves further investigation given that malnutrition, as determined using this tool, had a better overall predictive value of cancer patients' survival than the proposed diagnostic criteria for cachexia.

Disclosure

All authors have declared no conflicts of interest.