O061 - MALNUTRITION IN CANCER AND ITS ASSOCIATION WITH CACHEXIA USING DIFFERENT CACHEXIA DIAGNOSTIC ALGORITHMS – POTENTIAL ROLE FOR INSCOC CACHEXIA CRITERIA

O061

MALNUTRITION IN CANCER AND ITS ASSOCIATION WITH CACHEXIA USING DIFFERENT CACHEXIA DIAGNOSTIC ALGORITHMS – POTENTIAL ROLE FOR INSCOC CACHEXIA CRITERIA

Z. Bu¹, C. Liu², R. Barazzoni³, S. V. Haehling⁴, Y. Wang^1,*, H. Shi⁵

¹Clinical Nutrition, Beijing Shijitan Hospital, ²Comprehensive Oncology Department, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China, ³Medical, University of Trieste, Trieste, Italy, ⁴Cardiology and Pneumology, University of Göttingen Medical Centre, Göttingen, Germany, ⁵Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China

Rationale: There is significant overlap in the definition and diagnosis of cachexia and malnutrition, especially in patients with cancer. Identifying the conditions correctly is essential for improving clinical care. This study examined overlap and discrepancies between cancer cachexia and malnutrition.

Methods: The prospective multicenter cohort INSCOC study involving 18,278 patients with cancer was conducted from 2013 to 2021. Time-dependent area under curve (time-AUC) and C-index were calculated to assess the predictive ability for mortality of the different diagnostic criteria for malnutrition and cachexia. In addition, we tested a diagnostic algorithm for cachexia from the current study cohort (INSCOC: cachexia based on graded weight loss, reduced food intake/ anorexia and one biochemical-metabolic criterion between low hemoglobin, high blood glucose, inflammatory markers and low albumin).

Results: The cohort included 18,278 participants (45.28% women; mean age 57.68 years) for the analysis. 100% of patients diagnosed with cachexia according to all criteria also had malnutrition based on PG-SGA, and 95.6%-98.1% had malnutrition according to GLIM criteria. As the severity of malnutrition increased, the incidence of cachexia rose accordingly.  When compared to other existing cachexia diagnostic algorithms, the INSCOC diagnostic criteria had the highest predictive value for mortality (time-AUC value; c-statistic: 0.62).

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Conclusion: We found high agreement between diagnosis of cachexia and malnutrition using established international consensus criteria. Cachexia diagnostic criteria deserve further investigation in the context of nutritional status; the INSCOC cachexia algorithm may better predict the prognosis of patients with cancer and should be tested in further populations.

Disclosure of Interest: None declared