FAACT-Anorexia Cachexia Scale: Cutoff Value for Anorexia Diagnosis in Advanced Non-Small Cell Lung Cancer Patients

• Published in: Nutrition and cancer Vol. 71; no. 3; pp. 409 - 417
• Main Authors: Turcott, Jenny Georgina, Oñate-Ocaña, Luis F., Soca-Chafre, Giovanny, Ramírez-Tirado, Laura-Alejandra, Flores-Estrada, Diana, Zatarain-Barrón, Zyanya Lucia, Arrieta, Oscar
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03.04.2019; Taylor & Francis Ltd
• Subjects: Adenocarcinoma - complications; Adenocarcinoma - drug therapy; Aged; Anorexia; Anorexia - diagnosis; Anorexia - therapy; Appetite; Cachexia; Cachexia - diagnosis; Cachexia - therapy; Cancer; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - drug therapy; Complications; Diagnosis; Diagnostic systems; Feeding Behavior; Female; Health risk assessment; Humans; Lung cancer; Lung Neoplasms - complications; Lung Neoplasms - drug therapy; Male; Malnutrition; Medical prognosis; Middle Aged; Non-small cell lung carcinoma; Quality of Life; Reference Values; Surveys and Questionnaires; Survival
• ISSN: 0163-5581; 1532-7914
• DOI: 10.1080/01635581.2018.1506488

Lung cancer (LC) has a high rate of anorexia, which negatively affects quality-of-life and prognosis; however prevalence values may vary as per diagnostic test. There is no standard for anorexia diagnosis, currently the anorexia cachexia scale (A/CS) has been proposed as a tool for diagnosing anorexia with a consensus cutoff value of ≤24, nonetheless a validated cutoff value is required. The A/CS was evaluated in advanced Non-Small Cell Lung Cancer (NSCLC) patients to establish a cutoff value. The appetite item from the QLQ-C30 questionnaire and survival served as a standard reference. The cutoff value was associated with clinical and nutritional characteristics along with quality-of-life. Three hundred and twelve (312) NSCLC patients were evaluated. The mean A/CS value was 31 ± 9 and the identified cutoff value was 32.5 (sensitivity: 80.3% and specificity: 85%). The proportion of anorexia accurately diagnosed with the cutoff value of 24 was 26%, while with 32 it was 50%. The A/CS cutoff value of 32 was associated with clinical parameters, nutritional consumption, and quality-of-life, and independently associated with overall survival. A score of ≤32 in the A/CS is proposed for anorexia diagnosis in order to identify patients at risk of complications involving malnutrition related to LC.