Diagnostic Criteria for the Classification of Cancer-Associated Weight Loss

Abstract

Purpose Existing definitions of clinically important weight loss (WL) in patients with cancer are unclear and heterogeneous and do not consider current trends toward obesity. Methods Canadian and European patients with cancer (n = 8,160) formed a population-based data set. Body mass index (BMI) and percent WL (%WL) were recorded, and patients were observed prospectively until death. Data were entered into a multivariable analysis controlling for age, sex, cancer site, stage, and performance status. Relationships for BMI and %WL to overall survival were examined to develop a grading system. Results Mean overall %WL was −9.7% ± 8.4% and BMI was 24.4 ± 5.1 kg/m2, and both %WL and BMI independently predicted survival (P < .01). Differences in survival were observed across five categories of BMI (< 20.0, 20.0 to 21.9, 22.0 to 24.9, 25.0 to 27.9, and ≥ 28.0 kg/m2; P < .001) and five categories of %WL (−2.5% to −5.9%, −6.0% to −10.9%, −11.0% to −14.9%, ≥ −15.0%, and weight stable (± 2.4%); P < .001). A 5 × 5 mat...