Early recognition of malnutrition and cachexia in the cancer patient: a position paper of a European School of Oncology Task Force

Aapro, Matti; Arends, Jann; Bozzetti, Federico; Fearon, K.C.H.; Grunberg, Steven M.; Herrstedt, Jørn; Hopkinson, Jane B.; Jacquelin-Ravel, N.; Jatoi, Aminah; Kaasa, Stein; Strasser, Florian

doi:10.1093/annonc/mdu085

Cited by 269 publications

(225 citation statements)

References 57 publications

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“…Due to the advances in oncological practice, which have resulted in improved morbidity and mortality rates for patients in recent years (73,74) , the relationship between nutritional status and QoL is becoming an important issue in oncology and almost all newly diagnosed cancer patients believe that nutrition has a role to play in their anticancer therapeutic strategy (75) . Recent work has suggested that the complex interplay between metabolic disruption and pro-inflammatory cytokines in CC often leads to physical, biochemical and nutritional deterioration which subsequently leads to poor QoL (76)(77)(78) . A recent systematic review reported a negative correlation between QoL and weight loss in 23/27 studies of patients with CC (79) .…”

Section: Quality Of Lifementioning

confidence: 99%

“…This multimodal approach would incorporate oral nutritional supplements, exercise and anti-inflammatory medications and has been advocated in the prevention and treatment of CC. Underpinning this approach are meta-analyses suggesting that each of the interventions components, while not unequivocally associated with improved outcome, is more likely than not to be beneficial (77,88,91,94,95) . The MENAC trial (a multimodal intervention of exercise, nutrition and anti-inflammatory medication plus standard care v. standard care alone) to prevent/attenuate cachexia will test the efficacy of a multi-dimensional approach during chemotherapy.…”

Section: Multimodal Approachesmentioning

confidence: 99%

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Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

et al. 2016

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An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

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Section: Quality Of Lifementioning

confidence: 99%

Section: Multimodal Approachesmentioning

confidence: 99%

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

et al. 2016

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“…The use of nutritional interventions in order to improve these outcomes has not been clearly established yet [35,37,38]. A meta-analysis on the influence of nutritional support on adverse outcomes in cancer patients, showed no advantage for the intervention arms [37].…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 99%

Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – A multicentre cohort study

Huisman

Veronese

Audisio

et al. 2016

European Journal of Surgical Oncology (EJSO)

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Somasundar, P S et al. (2016) Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients -a multicentre cohort study. European Journal of Surgical Oncology, 42 (7). pp. 1009 -1017 This version is available from Sussex Research Online: http://sro.sussex.ac.uk/60520/ This document is made available in accordance with publisher policies and may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the URL above for details on accessing the published version. Copyright and reuse:Sussex Research Online is a digital repository of the research output of the University.Copyright and all moral rights to the version of the paper presented here belong to the individual author(s) and/or other copyright owners. To the extent reasonable and practicable, the material made available in SRO has been checked for eligibility before being made available.Copies of full text items generally can be reproduced, displayed or performed and given to third parties in any format or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided that the authors, title and full bibliographic details are credited, a hyperlink and/or URL is given for the original metadata page and the content is not changed in any way. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Accepted Manuscript M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT

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“…Unintended weight and muscle loss have been strongly associated with reduced physical functioning [6], poor tolerance to anticancer therapy [7],decreased quality of life [8], and poor prognosis and survival [9]. Despite these facts and international efforts to classify and define the syndrome, evidence-based treatment options derived from large-scale randomized controlled trials are still limited [1]. Moreover, the symptoms associated with unintended cancer-related weight loss that impact the lives of patients the most, and their concerns and worries related to weight loss and its treatment have not been systematically assessed.…”

mentioning

confidence: 99%

The experience of weight loss and its associated burden in patients with non‐small cell lung cancer: results of an online survey

Rodríguez

Braverman

Aggarwal

et al. 2017

JCSM Clinical Reports

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Early recognition of malnutrition and cachexia in the cancer patient: a position paper of a European School of Oncology Task Force

Cited by 269 publications

References 57 publications

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later

Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – A multicentre cohort study

The experience of weight loss and its associated burden in patients with non‐small cell lung cancer: results of an online survey

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