Department of Gastrointestinal Surgery, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China.
Clin Nutr. 2024 Jun;43(6):1524-1531. doi: 10.1016/j.clnu.2024.05.018. Epub 2024 May 10.
Cachexia is prevalent in cancer patients. The conventional diagnostic criteria for cachexia are often based on Western evidence, lacking consensus for Asian populations. This study aims to compare Asian Working Group for Cachexia (AWGC) criteria with Fearon's criteria, assessing their differences in population characteristics and prognostic impact.
The clinical data of patients who underwent radical gastrectomy between 2013 and 2019 were prospectively collected. Cachexia diagnosis involves the utilization of either AWGC criteria and the previous international consensus proposed by Fearon et al. A scoring model is established based on the optional criteria according to the AWGC criteria. Univariate and multivariate logistic and Cox regression analysis were conducted to determine the independent effect factors for postoperative complications and overall survival.
In a total of 1330 patients, 461 met AWGC cachexia criteria and 311 met Fearon's criteria. Excluding 262 overlapping cases, those diagnosed solely with AWGC-cachexia had higher age and lower BMI, albumin, hemoglobin, and handgrip strength compared to those by Fearon's criteria alone. AWGC-cachexia independently increased the risk of postoperative complications, whereas Fearon's criteria did not. Patients with AWGC-cachexia also exhibited shorter overall survival than Fearon's criteria. The AWGC-based cachexia grading system effectively stratifies the risks of postoperative complications and mortality.
The AWGC criteria is more effective in diagnosing cancer cachexia in the Asian population and provide better prognostic indicators.
恶病质在癌症患者中普遍存在。恶病质的传统诊断标准通常基于西方证据，缺乏亚洲人群的共识。本研究旨在比较亚洲恶病质工作组（AWGC）标准和 Fearon 标准，评估它们在人群特征和预后影响方面的差异。
前瞻性收集了 2013 年至 2019 年间接受根治性胃切除术的患者的临床数据。恶病质的诊断涉及使用 AWGC 标准和 Fearon 等人提出的先前的国际共识。根据 AWGC 标准的可选标准建立评分模型。采用单因素和多因素逻辑回归和 Cox 回归分析确定术后并发症和总生存的独立影响因素。
在总共 1330 名患者中，461 名符合 AWGC 恶病质标准，311 名符合 Fearon 标准。排除 262 例重叠病例后，仅符合 AWGC 恶病质标准的患者年龄更高，BMI、白蛋白、血红蛋白和握力较低。与仅符合 Fearon 标准的患者相比，AWGC 恶病质独立增加了术后并发症的风险，而 Fearon 标准则没有。AWGC 恶病质患者的总生存期也短于 Fearon 标准。基于 AWGC 的恶病质分级系统有效地分层了术后并发症和死亡率的风险。
AWGC 标准在诊断亚洲人群中的癌症恶病质方面更有效，并提供了更好的预后指标。
