Table 2.
Parameters of comprehensive cachexia assessment and recommended tools
| Category | Parameter | Recommended tool(s) |
|---|---|---|
| Nutritional status | Whole body status | BW |
| Weight loss | % of usual healthy weight | |
| Food intake | % of required amount | |
| Energy and protein intakea | Kcal/kg/day, g/kg/day | |
| Micronutrient or macronutrient deficienciesa | Food diary or 24-hour recall and software-based analysis | |
| Body compositiona | Anthropometry BIA, CT or DEXA133 |
|
| Metabolic status | Systemic inflammation | Modified Glasgow Prognostic Score15 |
| Energy expenditurea | Indirect calorimetry | |
| Functional status | PS | ECOG/WHO index |
| Physical activity | ADL134 | |
| Dependency | Northwick Park Dependency Score135 | |
| Grip strengtha | Dynamometry | |
| Gait speeda | 4-metre gait speed test136 | |
| Nutritional barriers | Nutrition impact symptoms | PG-SGA137 Nutritional impact checklist23 |
| GI dysfunctions | Chewing, taste, swallowing, gut motility, constipation, diarrhoea, stenosis, malabsorption | Diagnostic interview, imaging tests, functional tests, visual analogue scales |
| Distressing symptoms | Symptom assessment and risk factors (cognition, emotion, depression) | ESAS138 |
| Psychological and social distress | Psychosocial assessment139 | FAACT140 EORTC QLQ-CAX24141 |
| Adverse events of medication | Possible adverse effects on appetite, GI tract, central nervous system, fatigue | Pharmacological counselling |
| Tumour status | Extent and activity of cancer disease, likelihood of response to anticancer treatment | Oncological counselling |
ADL, activities of daily living; BIA, bioelectrical impedance analysis; BW, body weight; CT, computed tomography; DEXA, dual X-ray absorptiometry; ECOG, Eastern Cooperative Oncology Group; ESAS, Edmonton Symptom Assessment System; EORTC, European Organisation for Research and Treatment of Cancer; FAACT, Functional Assessment of Anorexia/Cachexia Treatment; GI, gastrointestinal; PG-SGA, Patient-Generated Subjective Global Assessment; PS, performance status; QLQ-CAX24, cachexia-specific quality of life questionnaire; WHO, World Health Organization.
a
If available and appropriate, depending on resources available and the patient's capability.