Early recognition of anorexia through patient-generated assessment predicts survival in patients with oesophagogastric cancer


Autoři: Marc Abraham aff001;  Zoe Kordatou aff002;  Jorge Barriuso aff002;  Angela Lamarca aff002;  Jamie M. J. Weaver aff002;  Claudia Cipriano aff002;  George Papaxoinis aff002;  Alison Backen aff002;  Wasat Mansoor aff002
Působiště autorů: Department of Nutrition & Dietetics, The Christie NHS Foundation Trust, Manchester, United Kingdom aff001;  Department of Medical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom aff002;  Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom aff003
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224540

Souhrn

Cancer 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 ≤37/48 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 ≤37 (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 ≤37 (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.

Klíčová slova:

Anorexia nervosa – Cancer detection and diagnosis – Cancer treatment – Gastric cancer – Metastasis – Paleoanthropology – Weight loss


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Článek vyšel v časopise

PLOS One


2019 Číslo 11