A retrospective cohort study to investigate the incidence of cancer-related weight loss during chemotherapy in gastric cancer patients

Abstract

Purpose This study aimed to evaluate cancer-related weight loss (WL) after the start of first-line chemotherapy as a surrogate marker for cancer cachexia in patients with advanced gastric cancer. We investigated the incidence of WL and the relationship between WL and overall survival (OS) or adverse events. Methods We conducted a retrospective cohort study in 131 patients with advanced gastric cancer who received first-line systemic chemotherapy between September 1, 2010, and August 31, 2016, at Kurume University Hospital and Shizuoka Cancer Center Hospital. WL was defined in this study as weight loss of > 5% or weight loss of > 2% with a body mass index of < 20 kg/m2 within the last 6 months after the start of chemotherapy. Results Median age and median Eastern Cooperative Oncology Group performance status of the patients participating in this study were 68 years old and 0, respectively. Incidence of WL was 53% at the first 12 weeks after starting first-line chemotherapy, and increased to 88% after 48 weeks. Overall survival rates were significantly associated with WL at 12, 24, and 48 weeks. Appetite loss and fatigue were more frequent and more severe in patients with WL. Conclusion WL was especially observed in more than half the patients within 12 weeks after starting chemotherapy. WL appeared to relate to adverse events or reduced survival. These results suggest the importance of monitoring WL or providing nutritional support at the beginning of chemotherapy.

A Retrospective Cohort Study to Investigate the Incidence of Cachexia During Chemotherapy in Patients with Colorectal Cancer

“…Notably, about 40% of the patients had early onset cancer cachexia (by 12 weeks) after starting first-line chemotherapy. Similar early onsets were observed in patients with pancreatic ductal adenocarcinoma or advanced gastric cancer [ 11 , 12 ]. On the other hand, these trends appear to differ from that observed in patients with advanced NSCLC since the incidence of cancer cachexia was about 25% in this population at the early time point and was relatively constant over time [ 10 ].…”

“…Although the overall survival (OS) was not significantly different between patients with and without cancer cachexia during chemotherapy, some adverse events (AEs) tended to be more frequent in patients with cancer cachexia. In patients with advanced gastric cancer, cancer cachexia was especially observed in more than half of the patients within 12 weeks after starting chemotherapy, and the cancer cachexia appeared to relate to the severity of AEs or reduced survival [12].…”

Role of Nutritional Care and General Guidance for Patients with Advanced or Metastatic Gastric Cancer

“…In one prospective, observational study conducted at 27 medical oncology centers including 1913 patients, those with gastroesophageal cancer had the highest frequency of malnutrition (48%) compared with other primary tumor types (malnutrition was reported for 36% of patients with head and neck cancer, 33% with lung cancer, 27% with hematological tumors and 24% with colorectal cancer) [12]. Another retrospective cohort study showed the incidence of weight loss of >5%, or of weight loss of >2% with a BMI of <20 kg/m 2 , was 53% at 12 weeks after starting first-line chemotherapy and 88% after 48 weeks [13]. Weight loss has also been reported as a prognostic factor for survival in patients with advanced gastric cancer receiving second-line chemotherapy [14].…”

Neutralization of the induced VEGF-A potentiates the therapeutic effect of an anti-VEGFR2 antibody on gastric cancer in vivo

“…Body weight loss during tumor progression is a typical phenotype of cachexia and gastric cancer patients have the highest incidence of cachexia 47 , 48 . In particular, the MKN45 cell-derived xenograft that we used in this study is a well-known model of tumor-induced cachexia 48 .…”