Fearon · The Lancet. Oncology 2011 · Expert consensus statement (focus groups and Delphi rounds) · n=?

Definition and classification of cancer cachexia: an international consensus.

Level 5 - mechanism / opinion, no new human data

Expert panel consensus statement using Delphi methodology without primary empirical data.

PubMed 21296615 · doi:10.1016/S1470-2045(10)70218-7 · record verified 2026-08-26

What was done

An international expert panel conducted a formal consensus process involving focus groups and two Delphi rounds to develop a standardized definition, diagnostic criteria, and classification framework for cancer cachexia.

What was found

Cancer cachexia was defined as a multifactorial syndrome with ongoing skeletal muscle loss (with or without fat loss) not fully reversible by conventional nutritional support. Agreed diagnostic criteria were weight loss >5%, or weight loss >2% in individuals with body-mass index <20 kg/m² or sarcopenia. The panel agreed on a three-stage clinical progression: precachexia, cachexia, and refractory cachexia, and identified key assessment domains including food intake, catabolic drive, muscle mass and strength, and functional/psychosocial impairment.

Why it matters

This paper provides the standard international consensus definition and staging criteria for cancer cachexia, establishing common thresholds for clinical trials and oncology practice.

Limits

The framework reflects expert consensus rather than prospective empirical data, and the criteria were unvalidated at the time of publication. The abstract does not report the total number of panel participants.

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