Publication

Definition and classification of cancer cachexia: an international consensus

Journal Paper/Review - Feb 4, 2011

Units
PubMed
Doi

Citation
Fearon K, Kaasa S, Wilcock A, Walsh D, Ravasco P, Radbruch L, Ottery F, Muscaritoli M, Davis M, Mantovani G, MacDonald N, Loprinzi C, Jatoi A, Fainsinger R, Bruera E, Bosaeus I, Anker S, Strasser F, Baracos V. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol 2011; 12:489-95.
Type
Journal Paper/Review (English)
Journal
Lancet Oncol 2011; 12
Publication Date
Feb 4, 2011
Issn Electronic
1474-5488
Pages
489-95
Brief description/objective

To develop a framework for the definition and classification of cancer cachexia a panel of experts participated in a formal consensus process, including focus groups and two Delphi rounds. Cancer cachexia was defined as a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. Its pathophysiology is characterised by a negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. The agreed diagnostic criterion for cachexia was weight loss greater than 5%, or weight loss greater than 2% in individuals already showing depletion according to current bodyweight and height (body-mass index [BMI] <20 kg/m(2)) or skeletal muscle mass (sarcopenia). An agreement was made that the cachexia syndrome can develop progressively through various stages--precachexia to cachexia to refractory cachexia. Severity can be classified according to degree of depletion of energy stores and body protein (BMI) in combination with degree of ongoing weight loss. Assessment for classification and clinical management should include the following domains: anorexia or reduced food intake, catabolic drive, muscle mass and strength, functional and psychosocial impairment. Consensus exists on a framework for the definition and classification of cancer cachexia. After validation, this should aid clinical trial design, development of practice guidelines, and, eventually, routine clinical management.