Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer)
Abstract Background Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortali...
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| Format: | Article |
| Language: | English |
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Wiley
2021-12-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12776 |
| _version_ | 1827271603600228352 |
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| author | Johanne Poisson Claudia Martinez‐Tapia Damien Heitz Romain Geiss Gilles Albrand Claire Falandry Mathilde Gisselbrecht Anne‐Laure Couderc Rabia Boulahssass Evelyne Liuu Pascaline Boudou‐Rouquette Anne Chah Wakilian Cedric Gaxatte Fréderic Pamoukdjian Laure deDecker Valery Antoine Catherine Cattenoz Heidi Solem‐Laviec Olivier Guillem Hayat Medjenah Pierre André Natella Florence Canouï‐Poitrine Marie Laurent Elena Paillaud |
| author_facet | Johanne Poisson Claudia Martinez‐Tapia Damien Heitz Romain Geiss Gilles Albrand Claire Falandry Mathilde Gisselbrecht Anne‐Laure Couderc Rabia Boulahssass Evelyne Liuu Pascaline Boudou‐Rouquette Anne Chah Wakilian Cedric Gaxatte Fréderic Pamoukdjian Laure deDecker Valery Antoine Catherine Cattenoz Heidi Solem‐Laviec Olivier Guillem Hayat Medjenah Pierre André Natella Florence Canouï‐Poitrine Marie Laurent Elena Paillaud |
| author_sort | Johanne Poisson |
| collection | DOAJ |
| description | Abstract Background Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortality. Methods A French nationwide cross‐sectional survey (performed in 55 geriatric oncology clinics) of older cancer patients aged ≥70 referred for geriatric assessment prior to treatment choice and initiation. Demographic, clinical, and nutritional data were collected. The first outcome was cachexia, defined as loss of more than 5% of bodyweight over the previous 6 months, or a body mass index below 20 kg/m2 with weight loss of more than 2%, or sarcopenia (an impaired Strength, Assistance with walking, Rise from chair, Climb stairs and Falls score) with weight loss of more than 2%. The second outcome was 6 month overall mortality. Results Of the 1030 patients included in the analysis [median age (interquartile range): 83 (79–87); males: 48%; metastatic cancer: 42%; main cancer sites: digestive tract (29%) and breast (16%)], 534 [52% (95% confidence interval: 49–55%)] had cachexia. In the multivariate analysis, patients with breast (P < 0.001), gynaecologic (P < 0.001), urinary (P < 0.001), skin (P < 0.001), and haematological cancers (P = 0.006) were less likely to have cachexia than patients with colorectal cancer. Patients with upper gastrointestinal tract cancers (including liver and pancreatic cancers; P = 0.052), with previous surgery for cancer (P = 0.001), with metastases (P = 0.047), poor performance status (≥2; P < 0.001), low food intake (P < 0.001), unfeasible timed up‐and‐go test (P = 0.002), cognitive disorders (P = 0.03) or risk of depression (P = 0.005), were more likely to have cachexia. At 6 months, 194 (20.5%) deaths were observed. Cachexia was associated with 6 month mortality risk (adjusted hazard ratio = 1.49; 95% confidence interval: 1.05–2.11) independently of age, in/outpatient status, cancer site, metastatic status, cancer treatment, dependency, cognition, and number of daily medications. Conclusions More than half of older patients with cancer managed in geriatric oncology clinics had cachexia. The factors associated with cachexia were upper gastrointestinal tract cancer, metastases, poor performance status, poor mobility, previous surgery for cancer, cognitive disorders, a risk of depression, and low food intake. Cachexia was independently associated with 6 month mortality. |
| first_indexed | 2024-04-11T20:16:44Z |
| format | Article |
| id | doaj.art-287d5f5827a640d4ae360f1727d2c3f3 |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2025-03-22T05:39:57Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-287d5f5827a640d4ae360f1727d2c3f32024-04-26T19:47:53ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092021-12-011261477148810.1002/jcsm.12776Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer)Johanne Poisson0Claudia Martinez‐Tapia1Damien Heitz2Romain Geiss3Gilles Albrand4Claire Falandry5Mathilde Gisselbrecht6Anne‐Laure Couderc7Rabia Boulahssass8Evelyne Liuu9Pascaline Boudou‐Rouquette10Anne Chah Wakilian11Cedric Gaxatte12Fréderic Pamoukdjian13Laure deDecker14Valery Antoine15Catherine Cattenoz16Heidi Solem‐Laviec17Olivier Guillem18Hayat Medjenah19Pierre André Natella20Florence Canouï‐Poitrine21Marie Laurent22Elena Paillaud23Assistance Publique – Hôpitaux de Paris (AP‐HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit Georges Pompidou European Hospital Paris FranceINSERM‐IMRB CEpiA (Clinical Epidemiology and Ageing Unit) Paris‐Est University, UPEC Créteil FranceOncology and Hematology Unit Strasbourg University Hospital Center ‐ Hautepierre Hospital Strasbourg FranceAssistance Publique – Hôpitaux de Paris (AP‐HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit Georges Pompidou European Hospital Paris FranceGeriatric Oncology Unit Antoine Charial hospital, Hospices Civils de Lyon Lyon FranceGeriatrics Unit Hospices Civils de Lyon Pierre‐Bénite FranceAssistance Publique – Hôpitaux de Paris (AP‐HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit Georges Pompidou European Hospital Paris FranceAP‐HM, Division of Internal Medicine, Geriatric Medicine and Therapeutic Sainte Marguerite Hospital Marseille FranceGeriatric Oncology Unit University Hospital of Nice Nice FranceGeriatric Department CHU La Milétrie Poitiers FranceAP‐HP, Medical Oncology Department, ARIANE Cochin Teaching Hospital Paris FranceGeriatric Department, Broca Hospital, Paris Centre Hospitals Paris Descartes University Paris FranceGeriatric Oncology Unit Lille University Hospital Lille FranceAP‐HP, Geriatric Oncology Unit Avicenne Hospital and Paris 13 University, Sorbonne Paris Cité Bobigny FranceClinical Gerontology Department Nantes University Hospital Center Nantes FranceDepartment of Geriatric Medicine Nimes University Hospital Nimes FranceMedical Oncology Department Eugène Marquis Center Rennes FranceGeriatric Oncology Unit, Oncology Supportive Care Department François Baclesse Regional Cancer Center Caen FranceGeriatric Medicine Unit Inter‐communal Hospital Center from Southern Alps Gap FrancePublic Health Department and Clinical Research Unit APHP, Henri‐Mondor Hospital Creteil FrancePublic Health Department and Clinical Research Unit APHP, Henri‐Mondor Hospital Creteil FranceINSERM‐IMRB CEpiA (Clinical Epidemiology and Ageing Unit) Paris‐Est University, UPEC Créteil FranceInternal Medicine and Geriatric Department, Paris‐ Sud‐Val‐de‐Marne Geriatric Oncology Clinic AP‐HP, Henri‐Mondor Hospital Créteil FranceAssistance Publique – Hôpitaux de Paris (AP‐HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit Georges Pompidou European Hospital Paris FranceAbstract Background Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortality. Methods A French nationwide cross‐sectional survey (performed in 55 geriatric oncology clinics) of older cancer patients aged ≥70 referred for geriatric assessment prior to treatment choice and initiation. Demographic, clinical, and nutritional data were collected. The first outcome was cachexia, defined as loss of more than 5% of bodyweight over the previous 6 months, or a body mass index below 20 kg/m2 with weight loss of more than 2%, or sarcopenia (an impaired Strength, Assistance with walking, Rise from chair, Climb stairs and Falls score) with weight loss of more than 2%. The second outcome was 6 month overall mortality. Results Of the 1030 patients included in the analysis [median age (interquartile range): 83 (79–87); males: 48%; metastatic cancer: 42%; main cancer sites: digestive tract (29%) and breast (16%)], 534 [52% (95% confidence interval: 49–55%)] had cachexia. In the multivariate analysis, patients with breast (P < 0.001), gynaecologic (P < 0.001), urinary (P < 0.001), skin (P < 0.001), and haematological cancers (P = 0.006) were less likely to have cachexia than patients with colorectal cancer. Patients with upper gastrointestinal tract cancers (including liver and pancreatic cancers; P = 0.052), with previous surgery for cancer (P = 0.001), with metastases (P = 0.047), poor performance status (≥2; P < 0.001), low food intake (P < 0.001), unfeasible timed up‐and‐go test (P = 0.002), cognitive disorders (P = 0.03) or risk of depression (P = 0.005), were more likely to have cachexia. At 6 months, 194 (20.5%) deaths were observed. Cachexia was associated with 6 month mortality risk (adjusted hazard ratio = 1.49; 95% confidence interval: 1.05–2.11) independently of age, in/outpatient status, cancer site, metastatic status, cancer treatment, dependency, cognition, and number of daily medications. Conclusions More than half of older patients with cancer managed in geriatric oncology clinics had cachexia. The factors associated with cachexia were upper gastrointestinal tract cancer, metastases, poor performance status, poor mobility, previous surgery for cancer, cognitive disorders, a risk of depression, and low food intake. Cachexia was independently associated with 6 month mortality.https://doi.org/10.1002/jcsm.12776CancerElderlyCachexiaMalnutritionScreeningPrognostic value |
| spellingShingle | Johanne Poisson Claudia Martinez‐Tapia Damien Heitz Romain Geiss Gilles Albrand Claire Falandry Mathilde Gisselbrecht Anne‐Laure Couderc Rabia Boulahssass Evelyne Liuu Pascaline Boudou‐Rouquette Anne Chah Wakilian Cedric Gaxatte Fréderic Pamoukdjian Laure deDecker Valery Antoine Catherine Cattenoz Heidi Solem‐Laviec Olivier Guillem Hayat Medjenah Pierre André Natella Florence Canouï‐Poitrine Marie Laurent Elena Paillaud Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) Journal of Cachexia, Sarcopenia and Muscle Cancer Elderly Cachexia Malnutrition Screening Prognostic value |
| title | Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) |
| title_full | Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) |
| title_fullStr | Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) |
| title_full_unstemmed | Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) |
| title_short | Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross‐sectional survey (NutriAgeCancer) |
| title_sort | prevalence and prognostic impact of cachexia among older patients with cancer a nationwide cross sectional survey nutriagecancer |
| topic | Cancer Elderly Cachexia Malnutrition Screening Prognostic value |
| url | https://doi.org/10.1002/jcsm.12776 |
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