Lung cancer (LC) is tied to an increased incidence of anorexia, which is known to have a negative impact on the quality-of-life and prognosis. The prevalence values may; however, differ, depending on the diagnostic test used.

Given the lack of a standard for diagnosing anorexia, the anorexia cachexia scale (A/CS) has been proposed as a tool for anorexia diagnosis with a consensus cutoff value of ≤24. However, there is still a need for a validated cutoff value.

Turcott and colleagues therefore, recently assessed the A/CS in patients with advanced Non-Small Cell Lung Cancer (NSCLC) to determine a cutoff value. The appetite item from the QLQ-C30 questionnaire and survival were used as a standard reference. The cutoff value was associated with clinical and nutritional characteristics and quality-of-life.

The evaluation involved 312 NSCLC patients. Mean A/CS value was 31 ± 9 and the identified cutoff value was 32.5, with a sensitivity of 80.3% and specificity of 85%. The proportion of anorexia accurately diagnosed with the cutoff value of 24 was 26%, but it was 50% with a cutoff value of 32. The A/CS cutoff value of 32 was shown to be associated with clinical parameters, nutritional consumption, and quality-of-life, and had an independent association with overall survival.

Investigators thus proposed a score of ≤32 in the A/CS for anorexia diagnosis for identifying patients at risk of complications involving malnutrition related to LC.

Source: Turcott JG, Oñate-Ocaña LF, Soca-Chafre G, et al. FAACT-Anorexia Cachexia Scale: Cutoff Value for Anorexia Diagnosis in Advanced Non-Small Cell Lung Cancer Patients. Nutrition and Cancer 2019;71(3):409-17.