The relationship between the BMI-adjusted weight loss grading system and quality of life in patients with incurable cancer

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dc.contributor.author Daly, Louise
dc.contributor.author Dolan, Ross
dc.contributor.author Power, Derek
dc.contributor.author Ní Bhuachalla, Éadaoin
dc.contributor.author Sim, Wei
dc.contributor.author Fallon, Marie
dc.contributor.author Cushen, Samantha
dc.contributor.author Simmons, Claribel
dc.contributor.author McMillan, Donald C.
dc.contributor.author Laird, Barry J.
dc.contributor.author Ryan, Aoife
dc.date.accessioned 2019-12-05T09:55:48Z
dc.date.available 2019-12-05T09:55:48Z
dc.date.issued 2019-11-06
dc.identifier.citation Daly, L., Dolan, R., Power, D., Ní Bhuachalla, É., Sim, W., Fallon, M., Cushen, S., Simmons, C., McMillan, D. C., Laird, B. J. and Ryan, A. 'The relationship between the BMI-adjusted weight loss grading system and quality of life in patients with incurable cancer', Journal of Cachexia, Sarcopenia and Muscle, in press. (9pp.) doi: 10.1002/jcsm.12499 en
dc.identifier.startpage 1 en
dc.identifier.endpage 9 en
dc.identifier.issn 2190-5991
dc.identifier.uri http://hdl.handle.net/10468/9333
dc.identifier.doi 10.1002/jcsm.12499 en
dc.description.abstract Background: Weight loss (WL) has long been recognized as an important factor associated with reduced quality of life (QoL) and reduced survival in patients with cancer. The body mass index (BMI)‐adjusted weight loss grading system (WLGS) has been shown to be associated with reduced survival. However, its impact on QoL has not been established. The aim of this study was to assess the relationship between this WLGS and QoL in patients with advanced cancer. Methods: A biobank analysis was undertaken of adult patients with advanced cancer. Data collected included patient demographics, Eastern Cooperative Oncology Group performance status, and anthropometric parameters (BMI and %WL). Patients were categorized according to the BMI‐adjusted WLGS into one of five distinct WL grades (grades 0–4). QoL was collected using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire‐C30. The Kruskal–Wallis test and multivariate logistic regression analyses were used to assess the relationship between the WLGS and QoL scores. Overall survival was assessed using Kaplan–Meier curve and Cox proportional hazard models. Results: A total of 1027 patients were assessed (51% male, median age: 66 years). Gastrointestinal cancer was most prevalent (40%), and 87% of patients had metastatic disease. Half (58%) of patients had a WL grade of 0–1, while 12%, 20%, and 10% had WL grades of 2, 3, and 4, respectively. Increasing WL grades were significantly associated with poorer QoL functioning and symptoms scales (all P < 0.05). Physical, role, and emotional functioning decreased by a median of >20 points between WL grade 0 and WL grade 4, while appetite loss, pain, dyspnoea, and fatigue increased by a median score >20 points, indicative of a large clinical significant difference. Increasing WL grades were associated with deteriorating QoL summary score. WL grades 2, 3, and 4 were independently associated with a QoL summary score below the median (<77.7) [odds ratio (OR) 1.69, P = 0.034; OR 2.06, P = 0.001; OR 4.29, P < 0.001, respectively]. WL grades 3 and 4 were independently associated with reduced overall survival [hazard ratio 1.54 (95% confidence interval: 1.22–1.93), P < 0.001 and hazard ratio 1.87 (95% confidence interval: 1.42–2.45), P < 0.001, respectively]. Conclusions: Our findings support that the WLGS is useful in identifying patients at risk of poor QoL that deteriorates with increasing WL grades. WL grade 4 is independently associated with a particularly worse prognosis and increased symptom burden. Identification and early referral to palliative care services may benefit these patients. en
dc.description.sponsorship Medical Research Scotland (Grant Number: 487 FRG) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher John Wiley & Sons Ltd. en
dc.rights ©2019The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting DisordersJournal of Cachexia, Sarcopenia and Muscle(2019)Published online in Wiley Online Library (wileyonlinelibrary.com)DOI:10.1002/jcsm.12499This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided theoriginal work is properly cited en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Cancer en
dc.subject Malnutrition en
dc.subject Weight loss en
dc.subject Cachexia en
dc.subject Quality of life en
dc.subject Survival en
dc.title The relationship between the BMI-adjusted weight loss grading system and quality of life in patients with incurable cancer en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Éadaoin Ní Bhuachalla, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland. +353-21-490-3000 Email:enibhuachalla@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Medical Research Scotland en
dc.contributor.funder Science Foundation Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Journal of Cachexia, Sarcopenia and Muscle en
dc.internal.IRISemailaddress enibhuachalla@ucc.ie en
dc.internal.bibliocheck Check, vol, issue and article ID en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2273/IE/Alimentary Pharmabiotic Centre (APC) - Interfacing Food & Medicine/ en
dc.identifier.eissn 2190-6009


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©2019The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting DisordersJournal of Cachexia, Sarcopenia and Muscle(2019)Published online in Wiley Online Library (wileyonlinelibrary.com)DOI:10.1002/jcsm.12499This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided theoriginal work is properly cited Except where otherwise noted, this item's license is described as ©2019The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting DisordersJournal of Cachexia, Sarcopenia and Muscle(2019)Published online in Wiley Online Library (wileyonlinelibrary.com)DOI:10.1002/jcsm.12499This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided theoriginal work is properly cited
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