Classification of Cancer Cachexia: A Systematic Review

Excerpt

Cachexia is a progressive wasting syndrome characterized by loss of weight and muscle mass, and changes in inflammatory and metabolic processes. Cachexia in patients with cancer is associated with poor outcomes including mortality, reduced quality of life, decreased physical and psychological functioning, and increased hospital length of stay. There are a variety of proposed algorithms to diagnosis and stage cancer cachexia; however, some include components that are not easily obtained in all settings and some algorithms may not distinguish cachexia from other related conditions such as malnutrition. Although multiple cancer cachexia diagnostic and staging algorithms are available, the effect of these strategies on clinical and patient-important outcomes remains unclear.

The VA Evidence Synthesis Program (ESP) was asked by the Veterans Health Administration (VHA) Nutrition Field Advisory Board for an evidence review on classification systems for staging cancer cachexia and the outcomes associated with cachexia stages. In this review, we first describe published classification strategies, their performance measures (eg, sensitivity and specificity), and then synthesize the association between cachexia and cachexia staging with clinical and patient-important outcomes.