The assessment of anorexia in patients with cancer: cut-off values for the FAACT–A/CS and the VAS for appetite

Blauwhoff‐Buskermolen, Susanne; Ruijgrok, Carolien; Ostelo, Raymond; Vet, Henrica C.W. de; Verheul, Henk M.W.; Schueren, Marian A.E. de van der; Langius, J.A.E.

doi:10.1007/s00520-015-2826-2

Cited by 65 publications

(62 citation statements)

References 14 publications

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“…Patients completed the following self‐assessment surveys: the visual analogue scale for food intake [Ingesta VAS (IVAS)], the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy questionnaire, the EORTC QLQ‐C30 questionnaire, and the short form of the International Physical Activity Questionnaire …”

Section: Methodsmentioning

confidence: 99%

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Antoun

Morel

Souquet

et al. 2019

J cachexia sarcopenia muscle

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Background An international consensus proposed in 2011 a definition and classification system for cachexia (CAX), mainly based on weight loss, sarcopenia [skeletal muscle mass (SMM) loss], inflammation, and anorexia. The aim of this study was to stage CAX in non‐small‐cell lung cancer (NSCLC) patients by using a classification based on the Fearon criteria and supported by quantifiable parameters. Methods This was a cross‐sectional and non‐interventional multicentre study. SMM was assessed by analysing L3 computed tomography‐scan images. Patients completed the anorexia/CAX subscale of the Functional Assessment of Anorexia/Cachexia Therapy, EORTC QLQ‐C30 quality of life (QoL) and International Physical Activity Questionnaire (IPAQ). Results Patients were recruited in 56 sites. The analysis population comprised 531 patients, and SMM was assessed in 312 patients. Male patients were 66.5%, with a mean (SD) age of 65.2 (10.0) years, 79.9% were PS 0–1, and the tumour stage was mainly IIIB‐IV (87.3%). Overall, 38.7% of patients had CAX, 33.8% pre‐CAX, and 0.9% refractory CAX. Molecular tumour profiles were significantly associated with the presence of CAX: 23.9% in EGFR, ALK, ROS1, BRAF, or HER2+ patients, 41.4% in K‐RAS+, and 43.2% in patients with no molecular abnormality ( P = 0.003). The more advanced the CAX stage, the poorer the scores of functional items of the QoL ( P < 0.001) and International Physical Activity Questionnaire ( P < 0.001). Sarcopenia was present in 66.7% of CAX and 68.5% of pre‐CAX patients. Overall, 43.8% of pre‐CAX patients had only sarcopenia with limited weight loss (≤2%) and no anorexia. Conclusions This is the first study to show the distribution of CAX in a population of NSCLC patients and an association between molecular abnormality in NSCLC and CAX. The original Fearon classification for CAX stages was supported by the associated functional QoL scores and physical activity levels, resulting in a clinically relevant system for detection of early stages of CAX.

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Section: Methodsmentioning

confidence: 99%

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Antoun

Morel

Souquet

et al. 2019

J cachexia sarcopenia muscle

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“…Subjects were asked to answer the question ‘Do you have appetite loss?’ (rated as 6‐point Likert scale 0 = not at all, 1 = very rarely, 2 = rarely, 3 = occasionally, 4 = frequently, and 5 = very frequently with higher number indicating increased frequency of anorexia). A cut‐off value ≥ 1 on the anorexia scale was used to define anorexia, because the response option ‘very rarely’ indicates that patients experience their appetite to be different from normal (‘not at all’), which was described by Blauwhoff‐Buskermolen …”

Section: Methodsmentioning

confidence: 99%

“…A cut-off value ≥ 1 on the anorexia scale was used to define anorexia, because the response option 'very rarely' indicates that patients experience their appetite to be different from normal ('not at all'), which was described by Blauwhoff-Buskermolen. 16 Nutritional assessment…”

Section: Evaluation Of Anorexiamentioning

confidence: 99%

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co‐morbidities Aggravating Heart Failure (SICA‐HF)

et al. 2017

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AimsWe aimed to assess determinants of anorexia, that is loss of appetite in patients with heart failure (HF) and aimed to further elucidate the association between anorexia, functional capacity, and outcomes in affected patients.Methods and resultsWe assessed anorexia status among 166 patients with HF (25 female, 66 ± 12 years) who participated in the Studies Investigating Co‐morbidities Aggravating HF. Anorexia was assessed by a 6‐point Likert scale (ranging from 0 to 5), wherein values ≥1 indicate anorexia. Functional capacity was assessed as peak oxygen uptake (peak VO2), 6 min walk test, and short physical performance battery test. A total of 57 patients (34%) reported any anorexia, and these patients showed lower values of peak VO2, 6 min walk distance, and short physical performance battery score (all P < 0.05). Using multivariate analysis adjusting for clinically important factors, only high‐sensitivity C‐reactive protein [odds ratio (OR) 1.24, P = 0.04], use of loop diuretics (OR 5.76, P = 0.03), and the presence of cachexia (OR 2.53, P = 0.04) remained independent predictors of anorexia. A total of 22 patients (13%) died during a mean follow‐up of 22.5 ± 5.1 months. Kaplan‐Meier curves for cumulative survival showed that those patients with anorexia presented higher mortality (Log‐rank test P = 0.03).ConclusionsInflammation, use of loop diuretics, and cachexia are associated with an increased likelihood of anorexia in patients with HF, and patients with anorexia showed impaired functional capacity and poor outcomes.

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“…Based on previous research, poor appetite was defined as a score ≤37 on the FAACT-A/CS questionnaire or ≤70 on the VAS for appetite. 19 Inflammation Plasma concentrations of C-reactive protein (CRP) were measured with an automated latex-enhanced immunoturbidimetric assay on a Modular P analyser (Roche Diagnostics, Almere, The Netherlands). 20 Inflammation was defined as a plasma CRP concentration of ≥8 mg/L (upper limit of normality of the VU University Medical Center).…”

Section: Anorexiamentioning

confidence: 99%

The influence of different muscle mass measurements on the diagnosis of cancer cachexia

Blauwhoff‐Buskermolen

Langius

Becker

et al. 2017

J cachexia sarcopenia muscle

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BackgroundProgressive loss of muscle mass is a major characteristic of cancer cachexia. Consensus definitions for cachexia provide different options to measure muscle mass. This study describes the effect of different methods to determine muscle mass on the diagnosis of cancer cachexia. In addition, the association of cachexia with other features of cachexia, quality of life, and survival was explored.MethodsPrior to chemotherapy, cachexia was assessed by weight loss, body mass index, and muscle mass measurements, the latter by mid‐upper arm muscle area (MUAMA), computed tomography (CT) scans, and bio‐electrical impedance analysis (BIA). In addition, appetite, inflammation, muscle strength, fatigue, quality of life, and survival were measured, and associations with cachexia were explored.ResultsIncluded were 241 patients with advanced cancer of the lung (36%), colon/rectum (31%), prostate (18%), or breast (15%). Mean age was 64 ± 10 years; 54% was male. Prevalence of low muscle mass was as follows: 13% with MUAMA, 59% with CT, and 93% with BIA. In turn, the prevalence of cachexia was 37, 43, and 48%, whereby weight loss >5% was the most prominent component of being defined cachectic. Irrespective of type of muscle measurement, patients with cachexia presented more often with anorexia, inflammation, low muscle strength, and fatigue and had lower quality of life. Patients with cachexia had worse overall survival compared with patients without cachexia: HRs 2.00 (1.42–2.83) with MUAMA, 1.64 (1.15–2.34) with CT, and 1.50 (1.05–2.14) with BIA.ConclusionsAlthough the prevalence of low muscle mass in patients with cancer depended largely on the type of muscle measurement, this had little influence on the diagnosis of cancer cachexia (as the majority of patients was already defined cachectic based on weight loss). New studies are warranted to further elucidate the additional role of muscle measurements in the diagnosis of cachexia and the association with clinical outcomes.

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The assessment of anorexia in patients with cancer: cut-off values for the FAACT–A/CS and the VAS for appetite

Cited by 65 publications

References 14 publications

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Staging of nutrition disorders in non‐small‐cell lung cancer patients: utility of skeletal muscle mass assessment

Anorexia, functional capacity, and clinical outcome in patients with chronic heart failure: results from the Studies Investigating Co‐morbidities Aggravating Heart Failure (SICA‐HF)

The influence of different muscle mass measurements on the diagnosis of cancer cachexia

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