Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, United States; University of Rochester NCI Community Oncology Research Program (UR NCORP), Rochester, NY, United States.
Department of Medicine, Brown University, Providence, RI, United States.
J Geriatr Oncol. 2019 May;10(3):415-419. doi: 10.1016/j.jgo.2018.08.008. Epub 2018 Sep 5.
Cancer cachexia, characterized by weight loss and sarcopenia, leads to a decline in physical function and is associated with poorer survival. Cancer cachexia remains poorly described in older adults with cancer. This study aims to characterize cancer cachexia in older adults by assessing its prevalence utilizing standard definitions and evaluating associations with components of the geriatric assessment (GA) and survival.
Patients with cancer older than 65 years of age who underwent a GA and had baseline CT imaging were eligible in this cross-sectional study. Cancer cachexia was defined by the international consensus definition reported in 2011. Sarcopenia was measured using cross-sectional imaging and utilizing sex-specific cut-offs. Associations between cachexia, sarcopenia, and weight loss with survival and GA domains were explored.
Mean age of 100 subjects was 79.9 years (66-95) and 65% met criteria for cancer cachexia. Cachexia was associated with impairment in instrumental activities of daily living (IADL) (p = .017); no significant association was found between sarcopenia or weight loss and IADL impairment. Cachexia was significantly associated with poorer survival (median 1.0 vs 2.1 years, p = .011).
Cancer cachexia as defined by the international consensus definition is prevalent in older adults with cancer and is associated with functional impairment and decreased survival. Larger prospective studies are needed to further describe cancer cachexia in this population.
癌症恶病质的特征是体重下降和肌肉减少症,导致身体功能下降,并与生存率降低相关。癌症恶病质在老年癌症患者中描述不足。本研究旨在通过利用标准定义评估其患病率,并评估其与老年综合评估(GA)和生存相关的各组成部分的相关性,来描述老年癌症患者的癌症恶病质。
本横断面研究纳入了接受 GA 并具有基线 CT 成像的 65 岁以上患有癌症的患者。癌症恶病质的定义采用 2011 年报告的国际共识定义。使用横断面成像并利用性别特异性截断值来测量肌肉减少症。探讨了恶病质、肌肉减少症和体重减轻与生存和 GA 领域的相关性。
100 名受试者的平均年龄为 79.9 岁(66-95 岁),65%符合癌症恶病质的标准。恶病质与工具性日常生活活动能力(IADL)受损有关(p=0.017);肌肉减少症或体重减轻与 IADL 受损之间没有显著相关性。恶病质与较差的生存显著相关(中位 1.0 年 vs 2.1 年,p=0.011)。
国际共识定义定义的癌症恶病质在老年癌症患者中较为常见,与功能障碍和生存率降低相关。需要更大的前瞻性研究来进一步描述这一人群中的癌症恶病质。