title: Cachexia in cancer: what is in the definition?
abstract: OBJECTIVE
  This study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia.
  
  
  METHODS
  Data collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearonet al's definition is based on weight loss, body mass index (BMI) and sarcopenia. Evanset alnuances the contribution of sarcopenia and attaches additional attention to abnormal biochemistry parameters, fatigue and anorexia. The mean OS rates were compared between patients with and without cachexia for both definitions.
  
  
  RESULTS
  Based on the population of 167 patients who enrolled, 70% developed cachexia according to Fearonet al's definition and 40% according to Evanset al's definition. The OS in the cachectic population is 0.97 and 0.55 years, respectively. The difference in OS between patients with and without cachexia is more significant using the diagnostic criteria of Evanset al. The focus of Fearonet alon weight loss and sarcopenia over-rates the assignment of patients to the cachectic group and OS rates have less prognostic value.
  
  
  CONCLUSIONS
  This study presents a correlation with prognosis in favour of Evanset al' definition as a tool for cachexia diagnosis. This means that weight loss and BMI decline are both key factors in patients with cancer leading to cachexia but less decisive as stated by Fearonet al. Instead, extra factors gain importance in order to predict survival, such as chronic inflammation, anaemia, protein depletion, reduced food intake, fatigue, decreased muscle strength and lean tissue depletion.
  
  
  BACKGROUND
  B300201112334.
authors.affiliation: Universitair Ziekenhuis Antwerpen (UZA) Wilrijkstraat , Edegem , Belgium.
authors.forename: Greetje
authors.initials: G
authors.lastname: Vanhoutte
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Mick
authors.initials: M
authors.lastname: van de Wiel
authors.affiliation: Scientific Coordination and Biostatistics , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Kristin
authors.initials: K
authors.lastname: Wouters
authors.affiliation: Department of Dietetics , University Hospital Antwerp (UZA) Oncology (MOCA) , Edegem , Belgium.
authors.forename: Michaël
authors.initials: M
authors.lastname: Sels
authors.affiliation: Department of Dietetics , University Hospital Antwerp (UZA) Oncology (MOCA) , Edegem , Belgium.
authors.forename: Linda
authors.initials: L
authors.lastname: Bartolomeeussen
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: De Keersmaecker
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Verschueren
authors.affiliation: Department of Clinical Biology , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Veronique
authors.initials: V
authors.lastname: De Vroey
authors.affiliation: Department of Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Annemieke
authors.initials: A
authors.lastname: De Wilde
authors.affiliation: Scientific Coordination and Biostatistics , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Smits
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Kin Jip
authors.initials: KJ
authors.lastname: Cheung
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Liesbeth
authors.initials: L
authors.lastname: De Clerck
authors.affiliation: Laboratory of Experimental Medicine and Pediatrics (LEMP) , University of Antwerp (UA) , Wilrijk , Belgium.
authors.forename: Petra
authors.initials: P
authors.lastname: Aerts
authors.affiliation: Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium.
authors.forename: Didier
authors.initials: D
authors.lastname: Baert
authors.affiliation: Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Vandoninck
authors.affiliation: Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Kindt
authors.affiliation: Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Schelfhaut
authors.affiliation: Department of Gastroenterology , Maria Middelares Medical Centre, AZ Maria Middelares Hospital , Gent , Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Vankerkhoven
authors.affiliation: Heilig Hart Hospital , Lier , Belgium.
authors.forename: Annelies
authors.initials: A
authors.lastname: Troch
authors.affiliation: Heilig Hart Hospital , Lier , Belgium.
authors.forename: Lore
authors.initials: L
authors.lastname: Ceulemans
authors.affiliation: Heilig Hart Hospital , Lier , Belgium.
authors.forename: Hanne
authors.initials: H
authors.lastname: Vandenbergh
authors.affiliation: Heilig Hart Hospital , Lier , Belgium.
authors.forename: Sven
authors.initials: S
authors.lastname: Leys
authors.affiliation: Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium.
authors.forename: Tim
authors.initials: T
authors.lastname: Rondou
authors.affiliation: Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium.
authors.forename: Elke
authors.initials: E
authors.lastname: Dewitte
authors.affiliation: Department of Gastroenterology , Sint Jozef Kliniek , Bornem , Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Maes
authors.affiliation: Department of Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Pauwels
authors.affiliation: Laboratory of Experimental Medicine and Pediatrics (LEMP) , University of Antwerp (UA) , Wilrijk , Belgium.
authors.forename: Benedicte
authors.initials: B
authors.lastname: De Winter
authors.affiliation: Endocrinology, Diabetology, Metabolic Diseases and Nutrition Pathology , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Van Gaal
authors.affiliation: Hepatobiliary Surgery University Hospital Antwerp (UZA), Edegem, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ysebaert
authors.affiliation: Department of Oncology (MOCA) , University Hospital Antwerp (UZA) , Edegem , Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Peeters
keywords: CANCER; CANCER SYNDROMES; NUTRITIONAL STATUS