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Poisson J, Martinez-Tapia C, Heitz D, et al. Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer). J Cachexia Sarcopenia Muscle. 2021;doi: 10.1002/jcsm.12776.
Poisson, J., Martinez-Tapia, C., Heitz, D., Geiss, R., Albrand, G., Falandry, C., Gisselbrecht, M., Couderc, A. L., Boulahssass, R., Liuu, E., Boudou-Rouquette, P., Chah Wakilian, A., Gaxatte, C., Pamoukdjian, F., de Decker, L., Antoine, V., Cattenoz, C., Solem-Laviec, H., Guillem, O., Medjenah, H., Natella, P. A., Canouï-Poitrine, F., Laurent, M., & Paillaud, E. (2021). Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer). Journal of cachexia, sarcopenia and muscle, . https://doi.org/10.1002/jcsm.12776
Poisson, Johanne, et al. "Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer)." Journal of cachexia, sarcopenia and muscle vol. (2021). doi: https://doi.org/10.1002/jcsm.12776
Poisson J, Martinez-Tapia C, Heitz D, Geiss R, Albrand G, Falandry C, Gisselbrecht M, Couderc AL, Boulahssass R, Liuu E, Boudou-Rouquette P, Chah Wakilian A, Gaxatte C, Pamoukdjian F, de Decker L, Antoine V, Cattenoz C, Solem-Laviec H, Guillem O, Medjenah H, Natella PA, Canouï-Poitrine F, Laurent M, Paillaud E. Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer). J Cachexia Sarcopenia Muscle. 2021 Sep 14; doi: 10.1002/jcsm.12776. Epub 2021 Sep 14. PMID: 34519440.
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J Cachexia Sarcopenia Muscle. 2021 Sep 14; doi: 10.1002/jcsm.12776. Epub 2021 Sep 14.

Prevalence and prognostic impact of cachexia among older patients with cancer: a nationwide cross-sectional survey (NutriAgeCancer).

Journal of cachexia, sarcopenia and muscle

Johanne Poisson, Claudia Martinez-Tapia, Damien Heitz, Romain Geiss, Gilles Albrand, Claire Falandry, Mathilde Gisselbrecht, Anne-Laure Couderc, Rabia Boulahssass, Evelyne Liuu, Pascaline Boudou-Rouquette, Anne Chah Wakilian, Cedric Gaxatte, Fréderic Pamoukdjian, Laure de Decker, Valery Antoine, Catherine Cattenoz, Heidi Solem-Laviec, Olivier Guillem, Hayat Medjenah, Pierre André Natella, Florence Canouï-Poitrine, Marie Laurent, Elena Paillaud

Affiliations

  1. Assistance Publique - Hôpitaux de Paris (AP-HP), Paris Cancer Institute CARPEM, Geriatric Oncology Unit, Georges Pompidou European Hospital, Paris, France.
  2. Faculty of Health, University of Paris, Paris, France.
  3. INSERM-IMRB CEpiA (Clinical Epidemiology and Ageing Unit), Paris-Est University, UPEC, Créteil, France.
  4. Oncology and Hematology Unit, Strasbourg University Hospital Center - Hautepierre Hospital, Strasbourg, France.
  5. Geriatric Oncology Unit, Antoine Charial hospital, Hospices Civils de Lyon, Lyon, France.
  6. Geriatrics Unit, Hospices Civils de Lyon, Pierre-Bénite, France.
  7. AP-HM, Division of Internal Medicine, Geriatric Medicine and Therapeutic, Sainte Marguerite Hospital, Marseille, France.
  8. Geriatric Oncology Unit, University Hospital of Nice, Nice, France.
  9. Geriatric Department, CHU La Milétrie, Poitiers, France.
  10. AP-HP, Medical Oncology Department, ARIANE, Cochin Teaching Hospital, Paris, France.
  11. Geriatric Department, Broca Hospital, Paris Centre Hospitals, Paris Descartes University, Paris, France.
  12. Geriatric Oncology Unit, Lille University Hospital, Lille, France.
  13. AP-HP, Geriatric Oncology Unit, Avicenne Hospital and Paris 13 University, Sorbonne Paris Cité, Bobigny, France.
  14. Clinical Gerontology Department, Nantes University Hospital Center, Nantes, France.
  15. Department of Geriatric Medicine, Nimes University Hospital, Nimes, France.
  16. Medical Oncology Department, Eugène Marquis Center, Rennes, France.
  17. Geriatric Oncology Unit, Oncology Supportive Care Department, François Baclesse Regional Cancer Center, Caen, France.
  18. Geriatric Medicine Unit, Inter-communal Hospital Center from Southern Alps, Gap, France.
  19. Public Health Department and Clinical Research Unit, APHP, Henri-Mondor Hospital, Creteil, France.
  20. Internal Medicine and Geriatric Department, Paris- Sud-Val-de-Marne Geriatric Oncology Clinic, AP-HP, Henri-Mondor Hospital, Créteil, France.

PMID: 34519440 DOI: 10.1002/jcsm.12776

Abstract

BACKGROUND: Nutritional impairment is common in cancer patients and is associated with poor outcomes. Only few studies focused on cachexia. We assessed the prevalence of cachexia in older cancer patients, identified associated risk factors, and evaluated its impact on 6 month overall mortality.

METHODS: A French nationwide cross-sectional survey (performed in 55 geriatric oncology clinics) of older cancer patients aged ≥70 referred for geriatric assessment prior to treatment choice and initiation. Demographic, clinical, and nutritional data were collected. The first outcome was cachexia, defined as loss of more than 5% of bodyweight over the previous 6 months, or a body mass index below 20 kg/m

RESULTS: Of the 1030 patients included in the analysis [median age (interquartile range): 83 (79-87); males: 48%; metastatic cancer: 42%; main cancer sites: digestive tract (29%) and breast (16%)], 534 [52% (95% confidence interval: 49-55%)] had cachexia. In the multivariate analysis, patients with breast (P < 0.001), gynaecologic (P < 0.001), urinary (P < 0.001), skin (P < 0.001), and haematological cancers (P = 0.006) were less likely to have cachexia than patients with colorectal cancer. Patients with upper gastrointestinal tract cancers (including liver and pancreatic cancers; P = 0.052), with previous surgery for cancer (P = 0.001), with metastases (P = 0.047), poor performance status (≥2; P < 0.001), low food intake (P < 0.001), unfeasible timed up-and-go test (P = 0.002), cognitive disorders (P = 0.03) or risk of depression (P = 0.005), were more likely to have cachexia. At 6 months, 194 (20.5%) deaths were observed. Cachexia was associated with 6 month mortality risk (adjusted hazard ratio = 1.49; 95% confidence interval: 1.05-2.11) independently of age, in/outpatient status, cancer site, metastatic status, cancer treatment, dependency, cognition, and number of daily medications.

CONCLUSIONS: More than half of older patients with cancer managed in geriatric oncology clinics had cachexia. The factors associated with cachexia were upper gastrointestinal tract cancer, metastases, poor performance status, poor mobility, previous surgery for cancer, cognitive disorders, a risk of depression, and low food intake. Cachexia was independently associated with 6 month mortality.

© 2021 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders.

Keywords: Cachexia; Cancer; Elderly; Malnutrition; Nutritional support; Prognostic value; Screening

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