title: Quality of life and survival survey of cancer cachexia in advanced non-small cell lung cancer patients-Japan nutrition and QOL survey in patients with advanced non-small cell lung cancer study.
abstract: Although cancer cachexia is mainly characterized by persistent loss of body weight (BW), usually in response to a malignancy, the pathophysiology of cachexia remains unresolved. To elucidate the relationship between the loss of BW and other related clinical factors, we conducted a nationwide, multi-institutional, prospective, observational study in patients with advanced non-small cell lung cancer (NSCLC).
  
  
  
  Treatment-naïve stage IV NSCLC patients with an Eastern Cooperative Oncology Group performance status (PS) of 0-2 were eligible. BW, handgrip strength (HGS), quality of life (QOL), Karnofsky Performance Scale (KPS), biochemical parameters, and survival were evaluated at baseline and every 4 weeks for 1 year. The relationship between BW loss and other factors was examined by linear regression analysis. Estimated survival curves were drawn by the Kaplan-Meier method and applied by the log-rank test. Clinical factors associated with cancer cachexia were identified through principal component analysis. The generalized estimating equation approach was used to analyze the deterioration of QOL resulting from the progression of cachexia.
  
  
  
  A total of 406 patients were analyzed. BW loss was significantly associated with worsening of QOL, HGS, KPS, and biochemical parameters. The incidence of BW loss was observed throughout the study period. Overall survival was significantly shorter in patients as BW loss progressed. BW loss, decrease in HGS, anorexia, and fatigue were identified as core factors of cachexia that contributed to the deterioration of QOL.
  
  
  
  BW loss most likely deteriorated QOL and shortened survival in patients with advanced NSCLC and should be closely monitored.
authors.affiliation: Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan. takayama@koto.kpu-m.ac.jp.|Department of Respirology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan. takayama@koto.kpu-m.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Takayama
authors.affiliation: Department of Thoracic Oncology, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Atagi
authors.affiliation: Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Imamura
authors.affiliation: Department of Internal Medicine, Niigata Cancer Center Hospital, Niigata, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Respiratory Medicine, Gunma Prefectural Cancer Center, Ota, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Minato
authors.affiliation: Center for Respiratory Diseases, Japan Community Health care Organization, Hokkaido Hospital, Sapporo, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Harada
authors.affiliation: Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
authors.affiliation: Department of Respiratory Medicine, Kyorin University Hospital, Mitaka, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Yokoyama
authors.affiliation: Department of Clinical Oncology, Japan Anti-Tuberculosis Association, Fukujuji Hospital, Kiyose, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Yoshimori
authors.affiliation: Department of Medical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takiguchi
authors.affiliation: Respiratory Center, Matsusaka Municipal Hospital, Matsusaka, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hataji
authors.affiliation: Department of Respiratory Medicine, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Department of Medical Oncology, National Hospital Organization Yamaguchi-Ube Medical Center, Ube, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Aoe
authors.affiliation: Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Young Hak
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Toneyama National Hospital, Toyonaka, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yokota
authors.affiliation: Department of Pulmonary Medicine, Funabashi Municipal Medical Center, Funabashi, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tabeta
authors.affiliation: Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tomii
authors.affiliation: Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Health Science on Supportive Medicine for Intractable Diseases, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Eguchi
authors.affiliation: Thoracic Oncology Research Group, Yokohama, Japan.
authors.forename: Koshiro
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001835:Body Weight; D002100:Cachexia / Q000209:etiology / Q000401:mortality*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Body weight loss; Handgrip strength; Karnofsky Performance Scale; Non-small cell lung cancer; Quality of life