Display options
Cite
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;12(6):1477-1488doi: 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, 12(6), 1477-1488. 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. 12,6 (2021): 1477-1488. 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 Dec;12(6):1477-1488. doi: 10.1002/jcsm.12776. Epub 2021 Sep 14. PMID: 34519440; PMCID: PMC8718093.
Copy Download .nbib Format: NLM
Share it on

J Cachexia Sarcopenia Muscle. 2021 Dec;12(6):1477-1488. 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 PMCID: PMC8718093 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

References

  1. J Am Med Dir Assoc. 2015 Mar;16(3):247-52 - PubMed
  2. J Cachexia Sarcopenia Muscle. 2021 Dec;12(6):1477-1488 - PubMed
  3. Cancer. 2012 Jul 1;118(13):3377-86 - PubMed
  4. J Geriatr Oncol. 2019 Nov;10(6):874-883 - PubMed
  5. Crit Rev Oncol Hematol. 2011 Aug;79(2):205-12 - PubMed
  6. BMJ Open. 2016 Sep 06;6(9):e011512 - PubMed
  7. Asia Pac J Clin Nutr. 2018;27(6):1216-1224 - PubMed
  8. Br J Nutr. 2004 Jul;92(1):105-11 - PubMed
  9. Eur J Surg Oncol. 2016 Jul;42(7):1009-17 - PubMed
  10. JPEN J Parenter Enteral Nutr. 2014 Feb;38(2):196-204 - PubMed
  11. J Psychiatr Res. 1975 Nov;12(3):189-98 - PubMed
  12. Int J Clin Oncol. 2019 Oct;24(10):1204-1213 - PubMed
  13. Nutr Cancer. 2019;71(1):50-60 - PubMed
  14. J Clin Med. 2020 Jun 11;9(6): - PubMed
  15. Nutr Cancer. 2012;64(4):535-42 - PubMed
  16. Lancet Oncol. 2011 May;12(5):489-95 - PubMed
  17. J Cachexia Sarcopenia Muscle. 2016 Mar;7(1):28-36 - PubMed
  18. Age Ageing. 2005 Nov;34(6):619-25 - PubMed
  19. JAMA. 1963 Sep 21;185:914-9 - PubMed
  20. J Am Geriatr Soc. 1991 Feb;39(2):142-8 - PubMed
  21. J Cachexia Sarcopenia Muscle. 2019 Oct;10(5):1143-1145 - PubMed
  22. J Clin Oncol. 2014 Aug 20;32(24):2595-603 - PubMed
  23. J Gastroenterol Hepatol. 2019 May;34(5):947-953 - PubMed
  24. J Nutr Health Aging. 2018;22(8):898-903 - PubMed
  25. Fam Pract. 1994 Sep;11(3):260-6 - PubMed
  26. J Geriatr Oncol. 2019 May;10(3):415-419 - PubMed
  27. Clin Nutr. 2017 Oct;36(5):1187-1196 - PubMed
  28. J Cachexia Sarcopenia Muscle. 2018 Jun;9(3):505-513 - PubMed
  29. Age Ageing. 2019 Jan 1;48(1):16-31 - PubMed
  30. Clin Nutr. 2017 Dec;36(6):1473-1482 - PubMed
  31. CA Cancer J Clin. 2019 Jan;69(1):7-34 - PubMed
  32. Support Care Cancer. 2014 Mar;22(3):773-81 - PubMed
  33. J Clin Oncol. 2012 May 20;30(15):1829-34 - PubMed
  34. Nutrition. 2019 Feb;58:65-68 - PubMed
  35. J Chronic Dis. 1987;40(5):373-83 - PubMed
  36. Eur J Haematol. 2014 Jul;93(1):9-18 - PubMed
  37. J Geriatr Oncol. 2018 Jan;9(1):74-80 - PubMed
  38. Clin Nutr. 2008 Dec;27(6):793-9 - PubMed
  39. J Geriatr Oncol. 2015 Nov;6(6):442-5 - PubMed
  40. J Surg Oncol. 2013 Sep;108(3):182-6 - PubMed
  41. J Cachexia Sarcopenia Muscle. 2019 Oct;10(5):956-961 - PubMed
  42. Clin Interv Aging. 2014 Sep 29;9:1645-60 - PubMed
  43. J Gerontol A Biol Sci Med Sci. 2015 Sep;70(9):1148-55 - PubMed
  44. Eur J Cancer. 2015 Jun;51(9):1164-87 - PubMed
  45. Am J Med. 1980 Oct;69(4):491-7 - PubMed
  46. J Geriatr Oncol. 2019 Sep;10(5):763-769 - PubMed
  47. Arch Gerontol Geriatr. 2020 Jan - Feb;86:103943 - PubMed
  48. Support Care Cancer. 2016 Jan;24(1):429-435 - PubMed
  49. J Clin Oncol. 2011 Sep 1;29(25):3457-65 - PubMed
  50. Aging Clin Exp Res. 2017 Feb;29(1):43-48 - PubMed
  51. JPEN J Parenter Enteral Nutr. 2016 Mar;40(3):355-66 - PubMed
  52. Ann Oncol. 2011 Oct;22(10):2325-9 - PubMed
  53. Oncologist. 2014 Mar;19(3):275-82 - PubMed
  54. J Cancer. 2019 Jul 10;10(18):4318-4325 - PubMed

Publication Types

Grant support