Definition and classification of cancer cachexia: An international consensus

Kenneth Fearon, Florian Strasser, Stefan D. Anker, Ingvar Bosaeus, Eduardo Bruera, Robin L. Fainsinger, Aminah Jatoi, Charles Loprinzi, Neil MacDonald, Giovanni Mantovani, Mellar Davis, Maurizio Muscaritoli, Faith Ottery, Lukas Radbruch, Paula Ravasco, Declan Walsh, Andrew Wilcock, Stein Kaasa, Vickie E. Baracos

Research output: Contribution to journalReview article

1998 Scopus citations

Abstract

To develop a framework for the definition and classification of cancer cachexia a panel of experts participated in a formal consensus process, including focus groups and two Delphi rounds. Cancer cachexia was defined as a multifactorial syndrome defined by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment. Its pathophysiology is characterised by a negative protein and energy balance driven by a variable combination of reduced food intake and abnormal metabolism. The agreed diagnostic criterion for cachexia was weight loss greater than 5%, or weight loss greater than 2% in individuals already showing depletion according to current bodyweight and height (body-mass index [BMI] <20 kg/m2) or skeletal muscle mass (sarcopenia). An agreement was made that the cachexia syndrome can develop progressively through various stages-precachexia to cachexia to refractory cachexia. Severity can be classified according to degree of depletion of energy stores and body protein (BMI) in combination with degree of ongoing weight loss. Assessment for classification and clinical management should include the following domains: anorexia or reduced food intake, catabolic drive, muscle mass and strength, functional and psychosocial impairment. Consensus exists on a framework for the definition and classification of cancer cachexia. After validation, this should aid clinical trial design, development of practice guidelines, and, eventually, routine clinical management.

Original languageEnglish (US)
Pages (from-to)489-495
Number of pages7
JournalThe Lancet Oncology
Volume12
Issue number5
DOIs
StatePublished - May 1 2011

ASJC Scopus subject areas

  • Oncology

Fingerprint Dive into the research topics of 'Definition and classification of cancer cachexia: An international consensus'. Together they form a unique fingerprint.

  • Cite this

    Fearon, K., Strasser, F., Anker, S. D., Bosaeus, I., Bruera, E., Fainsinger, R. L., Jatoi, A., Loprinzi, C., MacDonald, N., Mantovani, G., Davis, M., Muscaritoli, M., Ottery, F., Radbruch, L., Ravasco, P., Walsh, D., Wilcock, A., Kaasa, S., & Baracos, V. E. (2011). Definition and classification of cancer cachexia: An international consensus. The Lancet Oncology, 12(5), 489-495. https://doi.org/10.1016/S1470-2045(10)70218-7