Retrospective analysis reveals high cachexia prevalence and related mortality in advanced cancer, highlighting the need for earlier recognition and tailored palliative intervention.
Key Points
To evaluate the prevalence of cancer cachexia using four diagnostic frameworks and determine its contribution to mortality in patients with advanced cancer.
Retrospective analysis of 513 cancer-related deaths over 3 years (August 2020 to August 2023) at a specialist palliative care unit.
Diagnosed cancer cachexia using Evans, Fearon, GLIM, and modified Glasgow Prognostic Score frameworks incorporating clinical, biochemical, and CT body composition data.
Performed paired within-patient comparisons between measurements taken 30–90 days versus <30 days prior to death.
At least one cachexia definition was met by 91.9% (n=421/458) of patients, with individual criteria prevalence ranging from 67.6% (Fearon, n=171/253) to 91.6% (GLIM, n=262/286).
Cachexia directly contributed to 69.6% (n=199/286) of recorded cancer deaths.
Within 30 days before death, C-reactive protein increased significantly, while hemoglobin, albumin, body mass index, and adipose tissue indices significantly declined (all p<0.001).