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Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer

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Abstract

Purpose

Cancer cachexia (CC) is commonly seen in advanced lung cancer patients and associated with poor prognosis. However, little is known about CC that develops during chemotherapy. We evaluated the prognostic impact of CC and skeletal muscle wasting that develops during the course of chemotherapy in advanced non-small cell lung cancer (NSCLC) patients.

Methods

The clinical data of 134 newly diagnosed NSCLC patients were retrospectively reviewed. CC was defined as a body weight loss >5 or >2 % in patients with a body mass index of <20 kg/m2. CC was assessed at baseline (T1) and 3 months (T2), 6 months (T3), and 12 months (T4) after chemotherapy initiation. Skeletal muscle mass was assessed using the lumber skeletal muscle index (LSMI).

Results

The proportion of patients with CC at T1, T2, T3, and T4 was 45.6, 46.1, 25.5, and 26.0 %, respectively. The frequency of grade 3 chemotherapy-induced anorexia was higher in patients with CC than those without CC at T2 (15.4 vs. 0.0 %, P = 0.0044). At all time points, patients with CC had shorter survival times than those without CC. Patients with low LSMIs (men, <41 cm2/m2; women, <38 cm2/m2) tended to have poor prognosis. Adjusted Cox proportional hazard ratios and corresponding confidence intervals for CC at T1, T2, T3, and T4 were 2.53 (1.33–4.88), 1.97 (1.27–3.06), 3.86 (2.14–6.81), and 1.62 (0.80–3.16), respectively.

Conclusion

CC presence and decreased skeletal muscle mass are associated with poor prognosis in advanced NSCLC patients receiving chemotherapy.

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Acknowledgments

The authors thank Akira Tanuma, M.D., and Taro Okayama, a physiotherapist, for their constructive advice regarding this study.

Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, 411-8777, Shizuoka, Japan

    Madoka Kimura, Tateaki Naito, Hirotsugu Kenmotsu, Tetsuhiko Taira, Kazushige Wakuda, Takuya Oyakawa, Yasushi Hisamatsu, Takaaki Tokito, Hisao Imai, Hiroaki Akamatsu, Akira Ono, Kyoichi Kaira, Haruyasu Murakami, Toshiaki Takahashi & Nobuyuki Yamamoto

  2. Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan

    Madoka Kimura

  3. Department of Medicine and Molecular Science, Graduate School of Medicine, Gunma University, 3-39-15, Showa-machi, Maebashi, 371-8511, Gunma, Japan

    Hisao Imai

  4. Third Department of Internal Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan

    Hiroaki Akamatsu & Nobuyuki Yamamoto

  5. Department of Oncology Clinical Development, Graduate School of Medicine, Gunma University, 3-39-15, Showa-machi, Maebashi, 371-8511, Gunma, Japan

    Kyoichi Kaira

  6. Division of Diagnostic Radiology, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, 411-8777, Shizuoka, Japan

    Masahiro Endo

  7. Clinical Trial Coordination Office, Shizuoka Cancer Center, 1007, Shimonagakubo, Nagaizumi-cho, Sunto-gun, 411-8777, Shizuoka, Japan

    Keita Mori

Authors
  1. Madoka Kimura
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  2. Tateaki Naito
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  3. Hirotsugu Kenmotsu
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  4. Tetsuhiko Taira
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  5. Kazushige Wakuda
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  6. Takuya Oyakawa
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  7. Yasushi Hisamatsu
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  8. Takaaki Tokito
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  9. Hisao Imai
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  10. Hiroaki Akamatsu
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  11. Akira Ono
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  12. Kyoichi Kaira
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  13. Haruyasu Murakami
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  14. Masahiro Endo
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  15. Keita Mori
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  16. Toshiaki Takahashi
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Corresponding author

Correspondence to Tateaki Naito.

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Kimura, M., Naito, T., Kenmotsu, H. et al. Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer. Support Care Cancer 23, 1699–1708 (2015). https://doi.org/10.1007/s00520-014-2534-3

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  • DOI: https://doi.org/10.1007/s00520-014-2534-3

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