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Prognostic markers of overall survival in cancer patients attending a cachexia support service : An evaluation of clinically assessed physical function, malnutrition and inflammatory status
Bland, Kelcey A. Zopf, Eva M. Harrison, Meg Ely, Matthew Cormie, Prue Liu, E. Dowd, Anna Martin, Peter
Bland, Kelcey A.
Zopf, Eva M.
Harrison, Meg
Ely, Matthew
Cormie, Prue
Liu, E.
Dowd, Anna
Martin, Peter
Abstract
Background
Cancer cachexia is a muscle-wasting syndrome that results in physical function impairments and decreased survival. While body weight and muscle mass loss predict survival, the prognostic significance of physical function in this population is unclear. Thus, we evaluated the association between physical function, and other routine measures, and overall survival (OS) in cancer patients attending a cachexia support service.
Methods
Physical function was clinically-assessed using the 30 s sit-to-stand test and handgrip strength. Six-month weight loss, the Patient-Generated Subjective Global Assessment (PG-SGA) total score, C-reactive protein (CRP), albumin, and quality of life were also evaluated.
Results
Records from 203 patients (age: 68.6 ± 11.6 years) were included. Handgrip strength did not predict OS. Sit-to-stand repetitions predicted OS in the single variable, but not the multivariable analysis. Multivariable results suggested higher PG-SGA total scores (HR: 1.04, 95% CI: 1.01–1.07), six-month weight loss (HR: 1.02, 95% CI: 1.004–1.04), and elevated CRP (HR: 1.004, 95% CI: 1.0004–1.01) predicted shorter OS. Higher albumin predicted longer OS (HR: 0.93, 95% CI: 0.90–0.97).
Conclusion
Six-month weight loss, the PG-SGA total score, CRP, and albumin independently predicted survival, while physical function did not. Functional impairments remain a hallmark of cancer cachexia and the benefit of their routine assessment warrants further exploration, especially in relation to patient quality of life.
Keywords
Date
2020
Type
Journal article
Journal
Nutrition and Cancer
Book
Volume
73
Issue
8
Page Range
1400-1410
Article Number
ACU Department
School of Behavioural and Health Sciences
Faculty of Health Sciences
Mary MacKillop Institute for Health Research
Centre for Exercise and Nutrition
Faculty of Health Sciences
Mary MacKillop Institute for Health Research
Centre for Exercise and Nutrition
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled