Cancer cachexia is a common finding in patients with esophagogastric cancer (OG) and has been linked with overall survival (OS). Anorexia is the fundamental component of cachexia. However, it is not clearly understood if anorexia affects OS. Diagnosis always depends on description of symptoms by the patients, clinicians diagnosing anorexia and taking action.

For the purpose of this study, patients with esophageal/gastroesophageal junction or gastric cancer were assessed using the Functional Assessment of Anorexia Cachexia Therapy Anorexia/Cachexia Subscale (FAACT A/CS). FAACT A/CS comprises of 12 previously validated questions to diagnose anorexia in patients with cancer.

Overall, 182 patients were included in this evaluation. About 69% scored ≤37/48 and were considered to be anorexic. FAACT A/CS was found to be a better predictor of OS in metastatic patients than body mass index or weight loss in the six months prior to cancer diagnosis. The median OS of patients with FAACT A/CS scores of >37 was longer in comparison with patients having scores of ≤37 (19.3 months vs. 6.7 months). Patients with performance status (PS) 0–2 and FAACT A/CS >37 also had considerably longer OS compared to those with PS 0–2 and FAACT A/CS ≤37 (18.7 months vs 7.9 months).

The FAACT A/CS questionnaire enabled clinicians to identify patients with anorexia who may attain considerable benefit from early nutrition interventions. Additionally, this is the first study to show the link between anorexia and survival in patients with metastatic OG cancers.

Source: Abraham M, Kordatou Z, Barriuso J, et al. Early recognition of anorexia through patient-generated assessment predicts survival in patients with oesophagogastric cancer. PLoS One. 2019; 14(11): e0224540.