Prognostic value of cachexia defined by the Asian Working Group for Cachexia criteria in patients with gastric cancer  

作　　者：Hai-Lun Xie Li-Shuang Wei Shu-Yao Wang Chang-Hong Xu Guo-Tian Ruan He-Yang Zhang Han-Ping Shi Jun-Qiang Chen 

机构地区：[1]Department of Gastrointestinal Gland Surgery,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China [2]Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China [3]Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China [4]Center of Cancer Nutrition and Metabolism,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China [5]Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China [6]Guangxi Clinical Research Center for Enhanced Recovery after Surgery,The First Affiliated Hospital of GuangxiMedical University,Nanning 530021,Guangxi,China [7]and 7Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images,The First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China

出　　处：《Journal of Nutritional Oncology》2024年第2期63-71,I0001,共10页肿瘤营养学杂志（英文）

基　　金：supported by the Young Elite Scientists Sponsorship Program by CAST(No.2022QNRC001).

摘　　要：Background:The Asian Working Group for Cachexia(AWGC)criteria are newly proposed diagnostic standards specifically designed for Asian populations.This research focused on validating the predictive value of the AWGC criteria for assessing the prognosis and medical burden of patients with gastric cancer.Methods:Cox proportional hazards analysis was conducted to evaluate the association between cachexia and overall survival.Logistic regression analysis was used to assess whether there was an independent association between cachexia and the 90-day mortality,the length of stay and the quality of life.Harrell’s concordance index was utilized to demonstrate the discriminative ability of different diagnostic criteria for cachexia.Results:AWGC-defined cachexia was an independent risk factor for a reduced overall survival in patients(HR=1.397,95%CI=1.209–1.615,P<0.001).The predictive accuracy of the AWGC criteria was markedly superior to that of the Fearon criteria(χ2=39.025 vs 13.877).Compared with Fearon standards,the AWGC criteria offered a 2.9%enhancement in clinical benefit(0.029,95%CI=0.048–0.008,P=0.005).Logistic regression analysis showed that only AWGC-defined cachexia was an independent risk factor for 90-day mortality(OR=2.142,95%CI=1.397–3.282,P<0.001)and prolonged hospitalization(OR=1.958,95%CI=1.587–2.416,P<0.001)in patients with gastric cancer,whereas cachexia defined by the Fearon criteria was not.Patients with AWGC-defined cachexia exhibited significant reductions in physical function,role function,emotional function,cognitive function,social functioning,and overall quality-of-life scores.Conversely,cachectic patients showed higher levels of fatigue,nausea and vomiting,pain,dyspnea,sleep disturbance,appetite loss,constipation,and financial difficulties.A multivariate logistic regression showed that patients with AWGC-defined cachexia had a 126.1%increased risk of impaired quality of life(OR=2.261,95%CI=1.859–2.749,P<0.001).Conclusions:The AWGC criteria are an effective tool for predicting adve

关 键 词：CACHEXIA AWGC criteria SURVIVAL 90-Day mortality Gastric cancer 

分 类 号：R735.2[医药卫生—肿瘤]