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Abstract
Background
Cancer cachexia is a muscle-wasting syndrome that results in physical function impairments and decreased survival. While body weight and muscle mass loss predict survival, the prognostic significance of physical function in this population is unclear. Thus, we evaluated the association between physical function, and other routine measures, and overall survival (OS) in cancer patients attending a cachexia support service.
Methods
Physical function was clinically-assessed using the 30 s sit-to-stand test and handgrip strength. Six-month weight loss, the Patient-Generated Subjective Global Assessment (PG-SGA) total score, C-reactive protein (CRP), albumin, and quality of life were also evaluated.
Results
Records from 203 patients (age: 68.6 ± 11.6 years) were included. Handgrip strength did not predict OS. Sit-to-stand repetitions predicted OS in the single variable, but not the multivariable analysis. Multivariable results suggested higher PG-SGA total scores (HR: 1.04, 95% CI: 1.01–1.07), six-month weight loss (HR: 1.02, 95% CI: 1.004–1.04), and elevated CRP (HR: 1.004, 95% CI: 1.0004–1.01) predicted shorter OS. Higher albumin predicted longer OS (HR: 0.93, 95% CI: 0.90–0.97).
Conclusion
Six-month weight loss, the PG-SGA total score, CRP, and albumin independently predicted survival, while physical function did not. Functional impairments remain a hallmark of cancer cachexia and the benefit of their routine assessment warrants further exploration, especially in relation to patient quality of life.
Disclosure Statement
No potential conflict of interest was reported by the author(s).
Authorship Contributions
KB, EZ, PC, EL and PM conceived of the study design and analysis. PM, MH and ME are health care providers at the Barwon Health Cachexia and Nutritional Support Service in Geelong, Australia and conducted patient assessments and data collection during the study period. AD, MH and ME oversaw data extraction. KB extracted data from medical records, performed the data analysis, summarized the results and drafted the manuscript. All authors critically reviewed the manuscript and approved of the submitted version.