Validation of the Consensus-Definition for Cancer Cachexia and evaluation of a classification model: A study based on data from an international multicentre project (EPCRC-CSA)

D Blum (Corresponding Author), G. B. Stene, T.S. Solheim, P. Fayers, M. J. Hjermstad, V.E. Baracos, K. Fearon, F Strasser, S. Kaasa, Euro-Impact

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177 Citations (Scopus)


Weight loss limits cancer therapy, quality of life and survival. Common diagnostic criteria and a framework for a classification system for cancer cachexia were recently agreed upon by international consensus. Specific assessment domains (stores, intake, catabolism and function) were proposed. The aim of this study is to validate this diagnostic criteria (two groups: model 1) and examine a four-group (model 2) classification system regarding these domains as well as survival.

Patients and methods
Data from an international patient sample with advanced cancer (N = 1070) were analysed. In model 1, the diagnostic criteria for cancer cachexia [weight loss/body mass index (BMI)] were used. Model 2 classified patients into four groups 0-III, according to weight loss/BMI as a framework for cachexia stages. The cachexia domains, survival and sociodemographic/medical variables were compared across models.

Eight hundred and sixty-one patients were included. Model 1 consisted of 399 cachectic and 462 non-cachectic patients. Cachectic patients had significantly higher levels of inflammation, lower nutritional intake and performance status and shorter survival. In model 2, differences were not consistent; appetite loss did not differ between group III and IV, and performance status not between group 0 and I. Survival was shorter in group II and III compared with other groups. By adding other cachexia domains to the model, survival differences were demonstrated.

The diagnostic criteria based on weight loss and BMI distinguish between cachectic and non-cachectic patients concerning all domains (intake, catabolism and function) and is associated with survival. In order to guide cachexia treatment a four-group classification model needs additional domains to discriminate between cachexia stages.
Original languageEnglish
Pages (from-to)1635-1642
Number of pages8
JournalAnnals of Oncology
Issue number8
Early online date20 Feb 2014
Publication statusPublished - 1 Aug 2014

Bibliographical note

We would like to thank all people involved in the European Palliative Care Research Collaborative (EPCRC) and EURO IMPACT, European Intersectorial and Multidisciplinary Palliative Care Research Training.
EPCRC was funded by the European Union’s 6th 274 Support Care Cancer (2010) 18:273–279 framework in 2006 EURO IMPACT is funded by the European Union Seventh Framework Programme (FP7/2007–2013, under grant agreement no [264697]).


  • Cancer
  • Cachexia
  • Classification
  • Validation


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