Cachexia staging score predicts survival: a review

Article: Cachexia staging score predicts survival in patients with cancer who receive palliative care

The guidelines most commonly used to diagnose cachexia are the European Palliative Care Research Collaborative (EPCRC) guidelines. Here, cachexia is classified according to weight loss. However, for patients in palliative care with advanced cancer, there are often cases of oedema and ascites. This hampers the ability to detect weight loss, affecting the likelihood to be diagnosed with cachexia. Therefore, this study wished to examine the validity of diagnosing cachexia based upon other items. Alongside weight loss, this includes factors such as fatigue, decreasing muscle mass in the mid-upper arm, abnormal levels of white blood cells, reduced food intake and others. This study validated the CSS, Cachexia Staging Score, which demonstrated that patients without cachexia had a higher survival rate, and that the risk of mortality was higher with more severe cachexia. They also validated that cachexia prevalence was not significantly different compared to previous studies. Hence, such a multidimensional assessment helps to evaluate disorders including cachexia.

This review by Ueshima J et al. aimed to validate the Cachexia Staging Score for patients with advanced cancer who are under palliative care.

Key learnings

The Cachexia Staging Score accurately predicted life expectancy in advanced care patients who were receiving palliative care, and discriminated well the different stages of cachexia. However, more multi-centre studies are needed to confirm these results.

Reviewed by: Z. Beketova

Authors: Ueshima J, Maeda K, Shimizu A, et al.

Published in: Nutrition 2023