1586P - QOL and survival survey of cancer cachexia in advanced NSCLC patients – JNUQ-LC study, TORG0912

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Supportive Care
Non-Small-Cell Lung Cancer, Metastatic
Presenter Shinji Atagi
Authors S. Atagi1, F. Imamura2, A. Yokoyama3, K. Minato4, T. Harada5, N. Katakami6, T. Yokoyama7, Y. Ohashi8, K. Watanabe9, K. Eguchi10
  • 1Internal Medicine, Kinki-chuo Chest Medical Center, 591-8555 - Osaka/JP
  • 2Department Of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka/JP
  • 3Department Of Internal Medicine, Niigata Cancer Center Hospital, Niigata/JP
  • 4Department Of Respiratory Medicine, Gunma Prefectural Cancer Center, Ohta/JP
  • 5Hokkaido Social Insurance Hospital, Sapporo/JP
  • 6Division Of Integrated Oncology, Institute of Biomedical Research and Innovation Hospital, Kobe/JP
  • 7Department Of Respiratory Medicine, Kyorin University Hospital, Tokyo/JP
  • 8Department Of Biostatistics, School Of Public Health, The University of Tokyo, Tokyo/JP
  • 9Department Of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama/JP
  • 10Internal Medicine, Division Of Medical Oncology, Teikyo University School of Medicine, Tokyo/JP

Abstract

Background

Cancer cachexia, mainly characterized by muscle atrophy and subsequent cancer induced weight loss (CIWL), is attributed to about a third of cancer deaths. Despite worsening prognoses with the symptoms, clinical factors involved and the effect of CIWL to the overall status remain unexplained. We planned a prospective cohort study, Japan Nutrition and QOL survey in patients with advanced NSCLC study to investigate changes in CIWL in relation to grip, QOL, and clinical parameters to understand their effects on prognosis.

Method

Untreated stage IV NSCLC patients with ECOG PS of 0-2 were registered. Their body weight (BW), grip, QOL, Karnofsky Performance Scale, biochemical assay, and survival were recorded every four weeks for one year from the start of cancer treatments. Patients were classified by BW loss ≥ 5% and cachexia diagnosis by BW loss, fatigue, anorexia, and abnormal assay results. Estimated survival curves were drawn by Kaplan-Meier method, and Log-rank test was applied. To evaluate the effect of cancer cachexia attribution to QOL, we performed principal component analysis, factor analysis, and analysis on time course data using generalized estimating equation (GEE).

Results

Out of 466 patients registered, 406 were evaluable and analyzed. Patient characteristics were: median age: 67 (33-87) years, male/female ratio: 280/126, median BW: 56.5kg, PS 0: 39.2%, and PS 1: 51.5%. The patients with BW loss of ≥ 5% (n = 219) reported more early deaths than those without (n = 166, p < 0.0001). Patients with cachexia (n = 169) reported more early deaths than those without (n = 216, p < 0.0001). All correlations between principal component scores estimated from the variables considered the signs of cancer cachexia (cancer cachexia attributions: more weight on anorexia, fatigue, BW and grip) and each factor scores of QOL domains estimated from QOL factor analyses were significant (p < 0.01). From the time course data analyses using GEE, cancer cachexia attributions of each visit are shown as useful variables for all QOL domains (p < 0.01).

Conclusion

Cancer cachexia decreased QOL and possibly affected prognoses. Cachexia preventions and treatments based on the further elucidation of its pathology are needed.

Disclosure

All authors have declared no conflicts of interest.