每年出版 4 期
ISSN 打印: 0893-9675
ISSN 在线: 2162-6448
Indexed in
The Cachexia Clinic: From Staging to Managing Nutritional and Functional Problems in Advanced Cancer Patients
摘要
Panels of experts have agreed on the definition of cancer cachexia stages (CCS). We evaluated the clinical relevance of these stages and proposed ways to apply the CCSs to the clinical practice via standardized methods. The CCS were applied to 207 patients with advanced non-small-cell lung or gastrointestinal cancers from the Human Cancer Cachexia Database via consensus among the coauthors. Patients were categorized as noncachectic, precachectic, cachectic, and in refractory cachexia. Through analysis of variance, χ2, and Kaplan−Meier analyses, we tested the relationships between CCSs and selected outcomes. The CCS were significantly correlated (P < 0.05) with patient-centered indicators, including overall symptom burden, quality of life, tolerability to chemotherapy, body composition, hospital stay, and survival. However, precachectic and cachectic patients behaved similarly in all these outcomes but were significantly different from noncachectic and refractory cachectic patients. The average scores for the abridged Patient-Generated Subjective Global Assessment (aPG-SGA) corresponded well with the CCSs and reflected nicely the cut-off scores recommended for the nutritional triage of cancer patients. In addition to the aPG-SGA, we proposed the Edmonton Symptom Assessment System and routine laboratory tests for the triage of patients with refractory cachexia, for whom comfort care is the primary goal. The cachexia clinic hosted by the McGill Nutrition and Performance Laboratory offers a model for diagnosing more precisely the pathophysiology and severity of precachectic and cachectic conditions. The cachexia clinic, by working closely with palliative care programs, may offer the best environment for a comprehensive and personalized approach to the nutritional and functional problems in advanced cancer patients.
-
Macciò Antonio, Madeddu Clelia, Mantovani Giovanni, Current pharmacotherapy options for cancer anorexia and cachexia, Expert Opinion on Pharmacotherapy, 13, 17, 2012. Crossref
-
Fearon Kenneth, Arends Jann, Baracos Vickie, Understanding the mechanisms and treatment options in cancer cachexia, Nature Reviews Clinical Oncology, 10, 2, 2013. Crossref
-
Laviano Alessandro, Paldino Alessia, Diagnosing cachexia, Clinical Practice, 11, 1, 2014. Crossref
-
Wallengren Ola, Lundholm Kent, Bosaeus Ingvar, Diagnostic criteria of cancer cachexia: relation to quality of life, exercise capacity and survival in unselected palliative care patients, Supportive Care in Cancer, 21, 6, 2013. Crossref
-
Kilgour R. D., Vigano A., Trutschnigg B., Lucar E., Borod M., Morais J. A., Handgrip strength predicts survival and is associated with markers of clinical and functional outcomes in advanced cancer patients, Supportive Care in Cancer, 21, 12, 2013. Crossref
-
Lægreid Inger Karin, Aasarød Knut, Bye Asta, Leivestad Torbjørn, Jordhøy Marit, The impact of nutritional status, physical function, comorbidity and early versus late start in dialysis on quality of life in older dialysis patients, Renal Failure, 36, 1, 2014. Crossref
-
Alesi Erin R., del Fabbro Egidio, Opportunities for Targeting the Fatigue-Anorexia-Cachexia Symptom Cluster, The Cancer Journal, 20, 5, 2014. Crossref
-
Dev Rony, Del Fabbro Egidio, Bruera Eduardo, Outcomes of novel trials for cancer cachexia, Clinical Investigation, 4, 3, 2014. Crossref
-
Blum D., Stene G.B., Solheim T.S., Fayers P., Hjermstad M.J., Baracos V.E., Fearon K., Strasser F., Kaasa S., Block Lieve Van den, Koen Meeussen, Sarah Brearley, Augusto Caraceni, Joachim Cohen, Massimo Costantini, Anneke Francke, Richard Harding, Higginson Irene J., Stein Kaasa, Karen Linden, Guido Miccinesi, Bregje Onwuteaka-Philipsen, Koen Pardon, Roeline Pasman, Sophie Pautex, Sheila Payne, Luc Deliens, Validation of the Consensus-Definition for Cancer Cachexia and evaluation of a classification model—a study based on data from an international multicentre project (EPCRC-CSA), Annals of Oncology, 25, 8, 2014. Crossref
-
Vigano Antonio L., di Tomasso Jonathan, Kilgour Robert D., Trutschnigg Barbara, Lucar Enriqueta, Morais José A., Borod Manuel, The Abridged Patient-Generated Subjective Global Assessment Is a Useful Tool for Early Detection and Characterization of Cancer Cachexia, Journal of the Academy of Nutrition and Dietetics, 114, 7, 2014. Crossref
-
Kanat Ozkan, O’Neil Bert H, Cancer cachexia: an unmet need in cancer treatment, Clinical Investigation, 4, 7, 2014. Crossref
-
Tarricone Rosanna, Ricca Giada, Nyanzi-Wakholi Barbara, Medina-Lara Antonieta, Impact of cancer anorexia-cachexia syndrome on health-related quality of life and resource utilisation: A systematic review, Critical Reviews in Oncology/Hematology, 99, 2016. Crossref
-
Kilgour Robert D., Cardiff Katrina, Rosenthall Leonard, Lucar Enriqueta, Trutschnigg Barbara, Vigano Antonio, Use of prediction equations to determine the accuracy of whole-body fat and fat-free mass and appendicular skeletal muscle mass measurements from a single abdominal image using computed tomography in advanced cancer patients, Applied Physiology, Nutrition, and Metabolism, 41, 1, 2016. Crossref
-
Wesseltoft-Rao Nima, Hjermstad Marianne J., Ikdahl Tone, Dajani Olav, Ulven Stine M., Iversen Per Ole, Bye Asta, Comparing Two Classifications of Cancer Cachexia and Their Association with Survival in Patients with Unresected Pancreatic Cancer, Nutrition and Cancer, 67, 3, 2015. Crossref
-
Fuoco Domenico, Kilgour Robert D., Vigano Antonio, A hypothesis for a possible synergy between ghrelin and exercise in patients with cachexia: Biochemical and physiological bases, Medical Hypotheses, 85, 6, 2015. Crossref
-
Lerner Lorena, Tao Julie, Liu Qing, Nicoletti Richard, Feng Bin, Krieger Brian, Mazsa Elizabeth, Siddiquee Zakir, Wang Ruoji, Huang Lucia, Shen Luhua, Lin Jie, Vigano Antonio, Chiu M. Isabel, Weng Zhigang, Winston William, Weiler Solly, Gyuris Jeno, MAP3K11/GDF15 axis is a critical driver of cancer cachexia, Journal of Cachexia, Sarcopenia and Muscle, 7, 4, 2016. Crossref
-
Blauwhoff-Buskermolen Susanne, Langius Jacqueline A.E., Becker Annemarie, Verheul Henk M.W., de van der Schueren Marian A.E., The influence of different muscle mass measurements on the diagnosis of cancer cachexia, Journal of Cachexia, Sarcopenia and Muscle, 8, 4, 2017. Crossref
-
Zhou Ting, Yang Kaixiang, Thapa Sudip, Liu Huiquan, Wang Bangyan, Yu Shiying, Differences in Symptom Burden Among Cancer Patients With Different Stages of Cachexia, Journal of Pain and Symptom Management, 53, 5, 2017. Crossref
-
Beek Lies ter, Banning Louise B.D., Visser Linda, Roodenburg Jan L.N., Krijnen Wim P., van der Schans Cees P., Pol Robert A., Jager-Wittenaar Harriët, Risk for malnutrition in patients prior to vascular surgery, The American Journal of Surgery, 216, 3, 2018. Crossref
-
Allende-Pérez Silvia, Verástegui-Avilés Emma, Pérez-Camargo Dana A., Domínguez-Ocadio Georgina, Ferris Frank D., Palliative Care in Cervical Cancer Patients, in Cervical Cancer, 2017. Crossref
-
Vigano Antonio, Kasvis Popi, Di Tomasso Jonathan, Gillis Chelsia, Kilgour Robert, Carli Franco, Pearls of optimizing nutrition and physical performance of older adults undergoing cancer therapy, Journal of Geriatric Oncology, 8, 6, 2017. Crossref
-
Amano Koji, Ishiki Hiroto, Pathophysiology of Cancer Cachexia and Significance of Nutritional Support during the Treatment in Palliative Care, Palliative Care Research, 12, 2, 2017. Crossref
-
Letilovic Tomislav, Vrhovac Radovan, Krznarić Željko, Anthropometric and Laboratory Variables Related to Weight Loss—Comparison of Heart Failure Patients with Tumor Patients and Control Population, Frontiers in Nutrition, 4, 2017. Crossref
-
Vaitkus Janina A, Celi Francesco S, The role of adipose tissue in cancer-associated cachexia, Experimental Biology and Medicine, 242, 5, 2017. Crossref
-
Blum David, Erfassung und Klassifikation von Kachexie, in Kachexie bei Tumorerkrankungen, 2017. Crossref
-
van der Werf Anne, van Bokhorst Querijn N. E., de van der Schueren Marian A. E., Verheul Henk M. W., Langius Jacqueline A. E., Cancer Cachexia: Identification by Clinical Assessment versus International Consensus Criteria in Patients with Metastatic Colorectal Cancer, Nutrition and Cancer, 70, 8, 2018. Crossref
-
Baracos Vickie E., Martin Lisa, Korc Murray, Guttridge Denis C., Fearon Kenneth C. H., Cancer-associated cachexia, Nature Reviews Disease Primers, 4, 1, 2018. Crossref
-
Baracos Vickie E., Cancer-associated malnutrition, European Journal of Clinical Nutrition, 72, 9, 2018. Crossref
-
Shibata Masahiko, Gonda Kenji, Shimura Tatsuo, Sakurai Kenichi, Takenoshita Seiichi, SIRS, CARS and MARS in relationship to cancer cachexia and its clinical implications, Annals of Cancer Research and Therapy, 26, 1, 2018. Crossref
-
Zhou Ting, Wang Bangyan, Liu Huiquan, Yang Kaixiang, Thapa Sudip, Zhang Haowen, Li Lu, Yu Shiying, Development and validation of a clinically applicable score to classify cachexia stages in advanced cancer patients, Journal of Cachexia, Sarcopenia and Muscle, 9, 2, 2018. Crossref
-
Hui David, Paiva Carlos Eduardo, Del Fabbro Egidio G., Steer Christopher, Naberhuis Jane, van de Wetering Marianne, Fernández-Ortega Paz, Morita Tatsuya, Suh Sang-Yeon, Bruera Eduardo, Mori Masanori, Prognostication in advanced cancer: update and directions for future research, Supportive Care in Cancer, 27, 6, 2019. Crossref
-
Daou Hélène N., Exercise as an anti-inflammatory therapy for cancer cachexia: a focus on interleukin-6 regulation, American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 318, 2, 2020. Crossref
-
White Rhys, Weekes C. Elizabeth, Grant Robert, Baldwin Christine, Ahmed Hafez, Determining the prevalence and severity of cancer cachexia in advanced non-small cell lung cancer and its relationship with chemotherapy outcomes, Supportive Care in Cancer, 28, 9, 2020. Crossref
-
Biswas Anup K., Acharyya Swarnali, Understanding cachexia in the context of metastatic progression, Nature Reviews Cancer, 20, 5, 2020. Crossref
-
Hariyanto Timotius I., Kurniawan Andree, Cachexia in Cancer Patients: Systematic Literature Review, Asian Journal of Oncology, 06, 03, 2020. Crossref
-
Schütte Kerstin, Middelberg-Bisping Kristina, Schulz Christian, Nutrition and gastroenterological support in end of life care, Best Practice & Research Clinical Gastroenterology, 48-49, 2020. Crossref
-
Wiegert Emanuelly Varea Maria, de Oliveira Livia Costa, Calixto-Lima Larissa, Mota e Silva Lopes Márcia Soares da, Peres Wilza Arantes Ferreira, Cancer cachexia: Comparing diagnostic criteria in patients with incurable cancer, Nutrition, 79-80, 2020. Crossref
-
Gort-van Dijk Dorienke, Weerink Linda B.M., Milovanovic Milos, Haveman Jan-Willem, Hemmer Patrick H.J., Dijkstra Gerard, Lindeboom Robert, Campmans-Kuijpers Marjo J.E., Bioelectrical Impedance Analysis and Mid-Upper Arm Muscle Circumference Can Be Used to Detect Low Muscle Mass in Clinical Practice, Nutrients, 13, 7, 2021. Crossref
-
Amano Koji, Kiuchi Daisuke, Ishiki Hiroto, Matsuoka Hiromichi, Satomi Eriko, Morita Tatsuya, Clinical Implications of the Interdisciplinary Psychosocial Approach and Integrative Care for Patients with Advanced Cancer and Family Members in the Nutritional Support and Cancer Cachexia Clinic, Palliative Care Research, 16, 2, 2021. Crossref
-
Del Fabbro Egidio, Orr Tamara A., Stella Susan M., Practical approaches to managing cancer patients with weight loss, Current Opinion in Supportive & Palliative Care, 11, 4, 2017. Crossref
-
Permuth Jennifer, Dezsi Kaleena, Vyas Shraddha, Ali Karla, Basinski Toni, Utuama Ovie, Denbo Jason, Klapman Jason, Dam Aamir, Carballido Estrella, Kim Dae, Pimiento Jose, Powers Benjamin, Otto Amy, Choi Jung, Chen Dung-Tsa, Teer Jamie, Beato Francisca, Ward Alina, Cortizas Elena, Whisner Suzanne, Williams Iverson, Riner Andrea, Tardif Kenneth, Velanovich Vic, Karachristos Andreas, Douglas Wade, Legaspi Adrian, Allan Bassan, Meredith Kenneth, Molina-Vega Manual, Bao Philip, St. Julien Jamii, Huguet Kevin, Green Lee, Odedina Folakemi, Kumar Nagi, Simmons Vani, George Thomas, Vadaparampil Susan, Hodul Pamela, Arnoletti J., Awad Ziad, Bose Debashish, Jiang Kun, Centeno Barbara, Gwede Clement, Malafa Mokenge, Judge Sarah, Judge Andrew, Jeong Daniel, Bloomston Mark, Merchant Nipun, Fleming Jason, Trevino Jose, The Florida Pancreas Collaborative Next-Generation Biobank: Infrastructure to Reduce Disparities and Improve Survival for a Diverse Cohort of Patients with Pancreatic Cancer, Cancers, 13, 4, 2021. Crossref
-
Pal Vikas, Kumar Sachan Dheerendra, Kumar Nigam Akshay, Gupta Sumit, Sachan Ruchita, PREVALENCE OF CANCER INDUCED CACHEXIA IN NON-DIGESTIVE TRACT MALIGNANCES: AN OBSERVATIONAL STUDY, INDIAN JOURNAL OF APPLIED RESEARCH, 2021. Crossref
-
Gannavarapu Bhavani S., Lau Steven K.M., Carter Kristen, Cannon Nathan A., Gao Ang, Ahn Chul, Meyer Jeffrey J., Sher David J., Jatoi Aminah, Infante Rodney, Iyengar Puneeth, Prevalence and Survival Impact of Pretreatment Cancer-Associated Weight Loss: A Tool for Guiding Early Palliative Care, Journal of Oncology Practice, 14, 4, 2018. Crossref
-
Hui David, Cancer Cachexia: It Takes a Team to Fix the Complex Machinery, Journal of Oncology Practice, 12, 11, 2016. Crossref
-
Vigano Antonio A.L., Morais José A., Ciutto Lorella, Rosenthall Leonard, di Tomasso Jonathan, Khan Sarah, Olders Henry, Borod Manuel, Kilgour Robert D., Use of routinely available clinical, nutritional, and functional criteria to classify cachexia in advanced cancer patients, Clinical Nutrition, 36, 5, 2017. Crossref
-
Del Fabbro Egidio, Current and Future Care of Patients with the Cancer Anorexia-Cachexia Syndrome, American Society of Clinical Oncology Educational Book, 35, 2015. Crossref
-
Fram Julia, Vail Caroline, Roy Ishan, Assessment of Cancer-Associated Cachexia — How to Approach Physical Function Evaluation, Current Oncology Reports, 24, 6, 2022. Crossref
-
Vaughan Vanessa C, Martin Peter, Multidisciplinary approaches to cancer cachexia: current service models and future perspectives, Expert Review of Anticancer Therapy, 22, 7, 2022. Crossref