A prospective study examining cachexia predictors in patients with incurable cancer.
Cachexia
Cancer
Palliative care
Pre-cachexia
Weight loss
Journal
BMC palliative care
ISSN: 1472-684X
Titre abrégé: BMC Palliat Care
Pays: England
ID NLM: 101088685
Informations de publication
Date de publication:
04 Jun 2019
04 Jun 2019
Historique:
received:
31
08
2018
accepted:
20
05
2019
entrez:
6
6
2019
pubmed:
6
6
2019
medline:
20
12
2019
Statut:
epublish
Résumé
Early intervention against cachexia necessitates a predictive model. The aims of this study were to identify predictors of cachexia development and to create and evaluate accuracy of a predictive model based on these predictors. A secondary analysis of a prospective, observational, multicentre study was conducted. Patients, who attended a palliative care programme, had incurable cancer and did not have cachexia at baseline, were amenable to the analysis. Cachexia was defined as weight loss (WL) > 5% (6 months) or WL > 2% and body mass index< 20 kg/m Six-hundred-twenty-eight patients were included in the analysis. Median age was 65 years (IQR 17), 359(57%) were female and median Karnofsky performance status was 70(IQR 10). Median follow-up was 109 days (IQR 108), and 159 (25%) patients developed cachexia. Initial WL, cancer type, appetite and chronic obstructive pulmonary disease were significant predictors (p ≤ 0.04). A five-level model was created with each level carrying an increasing risk of cachexia development. For Risk-level 1-patients (WL < 3%, breast or hematologic cancer and no or little appetite loss), median time to cachexia development was not reached, while Risk-level 5-patients (WL 3-5%) had a median time to cachexia development of 51 days. Accuracy of cachexia predictions at 3 months was 76%. Important predictors of cachexia have been identified and used to construct a predictive model of cancer cachexia. ClinicalTrials.gov Identifier: NCT01362816 .
Sections du résumé
BACKGROUND
BACKGROUND
Early intervention against cachexia necessitates a predictive model. The aims of this study were to identify predictors of cachexia development and to create and evaluate accuracy of a predictive model based on these predictors.
METHODS
METHODS
A secondary analysis of a prospective, observational, multicentre study was conducted. Patients, who attended a palliative care programme, had incurable cancer and did not have cachexia at baseline, were amenable to the analysis. Cachexia was defined as weight loss (WL) > 5% (6 months) or WL > 2% and body mass index< 20 kg/m
RESULTS
RESULTS
Six-hundred-twenty-eight patients were included in the analysis. Median age was 65 years (IQR 17), 359(57%) were female and median Karnofsky performance status was 70(IQR 10). Median follow-up was 109 days (IQR 108), and 159 (25%) patients developed cachexia. Initial WL, cancer type, appetite and chronic obstructive pulmonary disease were significant predictors (p ≤ 0.04). A five-level model was created with each level carrying an increasing risk of cachexia development. For Risk-level 1-patients (WL < 3%, breast or hematologic cancer and no or little appetite loss), median time to cachexia development was not reached, while Risk-level 5-patients (WL 3-5%) had a median time to cachexia development of 51 days. Accuracy of cachexia predictions at 3 months was 76%.
CONCLUSION
CONCLUSIONS
Important predictors of cachexia have been identified and used to construct a predictive model of cancer cachexia.
TRIAL REGISTRATION
BACKGROUND
ClinicalTrials.gov Identifier: NCT01362816 .
Identifiants
pubmed: 31164115
doi: 10.1186/s12904-019-0429-2
pii: 10.1186/s12904-019-0429-2
pmc: PMC6549342
doi:
Banques de données
ClinicalTrials.gov
['NCT01362816']
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
46Subventions
Organisme : Marie Curie
ID : MCCC-RP-16-A20997
Pays : United Kingdom
Organisme : Helsinn
ID : NA
Organisme : Kreftforeningen
ID : NA
Organisme : Helse Midt-Norge
ID : 6070
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