Early recognition of anorexia through patient-generated assessment predicts survival in patients with oesophagogastric cancer
Weaver, Jamie M
Backen, Alison C
AffiliationDepartment of Nutrition & Dietetics, The Christie NHS Foundation Trust, Manchester
MetadataShow full item record
AbstractCancer cachexia is common in patients with oesophagogastric cancer (OG) and is linked to overall survival (OS). One of the key components of cachexia is anorexia; it is not known whether anorexia impacts on OS and there is no method of routine screening in current practice. Diagnosis relies on patients describing the symptoms, clinicians diagnosing anorexia and acting upon it. Patients with oesophageal/gastroesophageal junction or gastric cancer were assessed using the Functional Assessment of Anorexia Cachexia Therapy Anorexia/Cachexia Subscale (FAACT A/CS). FAACT A/CS includes 12 questions validated previously to diagnose anorexia in patients with cancer. Of the 182 patients included, 69% scored ²37/48 and were considered to be anorexic; FAACT A/CS was a better predictor of OS in metastatic patients than body mass index or weight loss in the six months prior to cancer diagnosis. The median OS of patients with FAACT A/CS scores of >37 was longer than patients with scores of ²37 (19.3 months vs 6.7 months, Hazard Ratio [HR] 2.9, 95% Confidence Interval [CI] 1.4-6.0, p<0.0001). Patients with performance status (PS) 0-2 and FAACT A/CS >37 had substantially longer OS than those with PS 0-2 and FAACT A/CS ²37 (18.7 months vs 7.9 months, HR 2.5 (95% CI 1.2-5.1, P<0.0001). The FAACT A/CS questionnaire allows clinicians to identify patients with anorexia who may benefit from early nutrition interventions. Importantly, this is the first study to show the association between anorexia and survival in patients with metastatic OG cancers. This will form the basis of future interventional studies to improve patient outcomes.
CitationAbraham M, Kordatou Z, Barriuso J, Lamarca A, Weaver JMJ, Cipriano C, et al. Early recognition of anorexia through patient-generated assessment predicts survival in patients with oesophagogastric cancer. PloS one. 2019;14(11):e0224540.
- The assessment of anorexia in patients with cancer: cut-off values for the FAACT-A/CS and the VAS for appetite.
- Authors: Blauwhoff-Buskermolen S, Ruijgrok C, Ostelo RW, de Vet HCW, Verheul HMW, de van der Schueren MAE, Langius JAE
- Issue date: 2016 Feb
- Validation and real-world assessment of the Functional Assessment of Anorexia-Cachexia Therapy (FAACT) scale in patients with advanced non-small cell lung cancer and the cancer anorexia-cachexia syndrome (CACS).
- Authors: LeBlanc TW, Samsa GP, Wolf SP, Locke SC, Cella DF, Abernethy AP
- Issue date: 2015 Aug
- Comprehensive validation of the functional assessment of anorexia/cachexia therapy (FAACT) anorexia/cachexia subscale (A/CS) in lung cancer patients with involuntary weight loss.
- Authors: Gelhorn HL, Gries KS, Speck RM, Duus EM, Bourne RK, Aggarwal D, Cella D
- Issue date: 2019 Jun
- Re-validation and shortening of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire.
- Authors: Ribaudo JM, Cella D, Hahn EA, Lloyd SR, Tchekmedyian NS, Von Roenn J, Leslie WT
- Issue date: 2000
- Validation of the Chinese version of functional assessment of anorexia-cachexia therapy (FAACT) scale for measuring quality of life in cancer patients with cachexia.
- Authors: Zhou T, Yang K, Thapa S, Fu Q, Jiang Y, Yu S
- Issue date: 2017 Apr