SCWD Publications Digest

Staying informed on the latest in cachexia, sarcopenia, and wasting disorders research is essential yet challenging. The SCWD Digest offers concise updates and expert insights into significant studies and developments. We highlight and link directly to leading research, making it easier for healthcare professionals to access and apply groundbreaking findings. Our goal: empower the medical community to advance patient care worldwide efficiently.

AllAgeingCachexiaCancer CachexiaClinical TrialsExerciseFrailtyFrom the literatureGuidelinesMuscleNutritionOther SCWD EventsSarcopenia

Body mass index, weight loss and survival in advanced lung cancer: a review

For patients with advanced-stage cancer, weight loss and lower body mass index has been associated with shorter rates of survival. On the other hand, obesity has been associated with longer survival. Weight loss or cachexia could therefore be used as a prognostic tool, although it has not yet been studied much in clinical trials. It is predicted to be due to the fact that decreased muscle mass is a predictor of shortened survival, as well as lowered nutrient stores and activity level. However, further research is required into understanding weight loss in relation to cancer survival rates, especially in the context of therapies such as chemotherapy, as it is not fully known how this interacts with body mass.
This review by Oswalt C et al. aimed to explore the relationship between body mass index, weight loss and survival rates in advanced lung cancer.

Read MoreBody mass index, weight loss and survival in advanced lung cancer: a review

Frailty instruments in patients with heart failure: a comparison of predictive performance

Frailty is characterised by increased vulnerability to acute stressors. As it is common in adults with heart failure (HF), frailty has been used as a predictor of mortality and morbidity for HF patients.
Frailty Phenotype, the most commonly used frailty instrument in HF, is used for the physical examination of frailty. While physical frailty instruments are commonly used in clinical practice, a proportion of studies have expressed issues with such tools. As HF may have detrimental effects on physical function, the use of physical instruments may lead to an under- or over-estimation of frailty.

This study aims to compare the predictive ability of three physical frailty instruments (the Frailty Phenotype, the St Vincent’s Frailty instrument and the SHARE-FI); and three multi-domain instruments (the FRAIL scale, the Deficit Accumulation Index, and St Vincent’s Frailty plus cognition 7 and mood) in adults with HF.

Read MoreFrailty instruments in patients with heart failure: a comparison of predictive performance

Knowledge gaps surrounding the definition, diagnosis, and management of sarcopenia

While it was initially characterised by a loss of muscle mass, sarcopenia has been defined by several international panels as a decline in muscle function, with a focus on muscle strength and physical performance. Despite the existence of algorithms and research into screening tools for its diagnosis, sarcopenia has not yet been appropriately recognised by the World Health Organisation’s latest version of the ICD (ICD-11), which is used by most countries. Definitions of sarcopenia are growing more precise, yet this does not translate into improved patient care and outcomes.

This article aims to summarise the knowledge gaps surrounding sarcopenia’s definition, diagnosis, and treatment in current clinical practice. It also highlights the next steps in achieving worldwide sarcopenia recognition.

Read MoreKnowledge gaps surrounding the definition, diagnosis, and management of sarcopenia

Sarcopenia: an adverse prognostic factor for patients with head and neck cancer?

Sarcopenia is characterised by progressive and generalised skeletal muscle loss, both in terms of mass and function. Its main risk factors include ageing, gender, sedentary lifestyles and malnutrition. The latter is also frequently diagnosed alongside head- and- neck squamous cell carcinomas (HNSCC), with up to 46%-49% of patients being malnourished upon diagnosis.
Although sarcopenia has been identified as a prognostic factor for HNSCC, only a small number of studies investigate the association between sarcopenia and survival in HNSCC.

This study aimed to assess the association between pre-therapeutic sarcopenia and survival, as well as its impact on tolerance of chemoradiotherapy for the treatment of HNSCC. The outcomes measured in this study were overall survival (OS), disease-free survival (DFS), and treatment tolerance.

Read MoreSarcopenia: an adverse prognostic factor for patients with head and neck cancer?

Clinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

Frailty is a state of vulnerability, recognised clinically, where patients experience an ageing-associated decline in their physical and cognitive abilities. There are two main scales for measuring frailty. The Clinical Frailty Scale (CFS) is often used for intensive care unit patients. The Diseases-10 Modified Frailty Index (mFI) is also used; it is derived from the understanding of 11 comorbidities. However, it was unknown how the two compare. In this study of 7,001 patients, it was found that a greater proportion of patients were categorised as frail using the CFS, and this scale also predicted better those who would survive past the 6-month mark versus those who would die. This indicates that the two scales are not equivalent, and the mFI should not be used for frailty.
This review by A. Subramaniam et al. aimed to highlight the differences between the two scales, the Clinical Frailty Scale and the Diseases-10 Modified Frailty Index, to determine which is a better predictor of frailty.

Read MoreClinical Frailty Scale and Frailty Index in Predicting Long-Term Survival for the Critically Ill: a review

Cancer cachexia and upper gastrointestinal cancers: a review

Globally, there are over 1.5 million new cases of gastric and oesophageal cancer annually. These cases (especially advanced cases) are often associated with cancer cachexia, a multifactorial syndrome that leads to progressive wasting which cannot be fully reverse through nutritional interventions. It is also responsible for around 20% of cancer deaths. Yet, the understanding of cancer cachexia is often neglected in treatment. This presents an issue as cytotoxic drug doses are most commonly calculated based on body surface area, not taking into account decreasing mass.
Furthermore, understanding cancer cachexia would allow for the improvement of therapeutic options, which are currently little researched, including exercise- and nutrition-based interventions, as well as targeted treatments such as anti-IL1 α and anti-GDF-15. Even for patients with incurable cancers, the management of cachexia wasting can improve quality of life.
This review by Brown LR et al. aimed to highlight the necessity of understanding the progression of cancer cachexia in association with diseases such as gastric and oesophageal cancer, as well as the possible future research directions associated with aiding in these conditions.

Read MoreCancer cachexia and upper gastrointestinal cancers: a review

Cancer cachexia and exercise-based therapy: a review

Cancer cachexia is a multifactorial syndrome that leads to progressive wasting which cannot be fully reverse through nutritional interventions. There is currently no clear method for the management of cachexia, but exercise seems to hold promising potential. Exercise may provide anti-inflammatory and anti-oxidative effects, which may prove important in aiding with cachexia due to its correlation with inflammation and oxidative stress. Furthermore, exercise improves muscle strength and function, which can improve quality of life for those with cancer cachexia. However, there is very scarce evidence for this, and even some evidence contradicting the benefit of exercise due to the risk of over-extending the patients.
This review by Murphy BT et al. aimed to shine light on both sides of the complex discussion surrounding the benefits of exercise in aiding with cancer cachexia.

Read MoreCancer cachexia and exercise-based therapy: a review

ESPEN Expert Group Recommendations for Action against Cancer-related Malnutrition

The ESPEN guidelines on cancer cachexia offer a comprehensive approach to understanding and managing cancer cachexia. Key recommendations are: These guidelines aim to shift the clinical approach towards a more proactive, multidisciplinary management of cancer cachexia, recognizing its critical impact…

📰 Journal: Clinical Nutrition
Read MoreESPEN Expert Group Recommendations for Action against Cancer-related Malnutrition

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