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A prospective study examining cachexia predictors in patients with incurable cancer.


ABSTRACT:

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

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/m2. Clinical and demographic markers were evaluated as possible predictors with Cox analysis. A classification and regression tree analysis was used to create a model based on optimal combinations and cut-offs of significant predictors for cachexia development, and accuracy was evaluated with a calibration plot, Harrell's c-statistic and receiver operating characteristic curve analysis.

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

Important predictors of cachexia have been identified and used to construct a predictive model of cancer cachexia.

Trial registration

ClinicalTrials.gov Identifier: NCT01362816 .

SUBMITTER: Vagnildhaug OM 

PROVIDER: S-EPMC6549342 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

A prospective study examining cachexia predictors in patients with incurable cancer.

Vagnildhaug Ola Magne OM   Brunelli Cinzia C   Hjermstad Marianne J MJ   Strasser Florian F   Baracos Vickie V   Wilcock Andrew A   Nabal Maria M   Kaasa Stein S   Laird Barry B   Solheim Tora S TS  

BMC palliative care 20190604 1


<h4>Background</h4>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.<h4>Methods</h4>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. Cachexi  ...[more]

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