Table 1.

Cancer cachexia classification [4]

0 = no cachexia
A	CRP > 10 or Alb < 32 g/dL or WBC > 11,000 or HgB < 120 g/L (men) 110 g/L (women)
B	Anorexia (ESAS appetite score ≥ 4/10) or decreased food intake (PG-SGA box 2 > 1)
C	≤ 5% WL over 6 months
Stage criteria	A alone, B alone or C alone or none of the above
1 = pre-cachexia
A	CRP > 10 or Alb < 32 g/dL or WBC > 11,000 or HgB < 120 g/L (men) 110 g/L (women)
B	Anorexia (ESAS appetite score ≥ 4/10) or decreased food intake (PG-SGA box 2 > 1)
C	≤ 5% WL over 6 months
Stage criteria	A + B or A + C or B + C or A + B + C
2a = cachexia
A	CRP > 10 or Alb < 32 g/dL or WBC > 11,000 or HgB < 120 g/L (men) 110 g/L (women)
B	Anorexia (ESAS appetite score ≥ 4/10) or decreased food intake (PG-SGA box 2 > 1)
D	> 5% WL over 6 months
E	PG-SGA box 4 ≤ 2 or hand-grip percentile ≥ 50
Stage cachexia	A + D + E or B + D + E or A + B + D + E
2b = cachexia caused by low BMI or sarcopenia
A	CRP > 10 or Alb < 32 g/dL or WBC > 11,000 or HgB < 120 g/L (men) 110 g/L (women)
B	Anorexia (ESAS appetite score ≥ 4/10) or decreased food intake (PG-SGA box 2 > 1)
E	PG-SGA box 4 ≤ 2 or hand-grip percentile ≥ 50
F	BMI < 20 + WL > 2% or sarcopenia + WL > 2%, male sarcopenia: ASMI < 7.26 kg/m2, female sarcopenia: ASMI < 5.45 kg/m2
Stage criteria	A + E + F or B + E + F or A + B + E + F
3 = refractory cachexia
A	CRP > 10 or Alb < 32 g/dL or WBC > 11,000 or HgB < 120 g/L (men) 110 g/L (women)
B	Anorexia (ESAS appetite score ≥ 4/10) or decreased food intake (PG-SGA box 2 > 1)
D	> 5% WL over 6 months
G	PG-SGA box 4 > 2 or hand-grip percentile < 50
Stage criteria	A + D + G or B + D + G or A + B + D + G

Alb albumin, ASMI appendicular skeletal muscle index, BMI body mass index, CRP C-reactive protein, ESAS Edmonton Symptom Assessment System, HgB haemoglobin, PG-SGA Patient-Generated Subjective Global Assessment, WBC white blood cell, WL weight loss