Functional Outcomes and Quality of Life for Patients With Cachexia and Solid Tumour Cancers: Findings of a Systematic Literature Review.
Level 3 - non-randomized controlled study
Systematic literature review of predominantly observational cohort studies (35 of 37 unique studies)
PubMed 42374134 · doi:10.1002/jcsm.70319
What was done
Systematic literature review searching Embase, MEDLINE, and Cochrane Library (2018–2023) for studies evaluating physical function, activities of daily living, and health-related quality of life (HRQoL) in adult patients with solid tumor cancers and cachexia. Thirty-seven unique studies from 40 publications covering 52,053 patients (sample sizes 38 to ~17,000; mean/median age 45 to 79.6 years; 35 observational studies, 2 post hoc analyses of randomized trials) were analyzed via narrative synthesis.
What was found
Across 40 publications, 11 distinct definitions of cachexia or body weight loss were used, with the Fearon et al. 2011 criteria being the most common (18/40, 45.0%). Nineteen outcome types were evaluated (11 only in univariate analyses, 8 in multivariate analyses). Statistically significant impairments associated with cachexia or weight loss were reported in: - 100% of studies measuring activities of daily living (6/6) - 91.7% of studies measuring HRQoL (22/24) - 87.5% of studies measuring performance status (14/16) - 80.6% of studies measuring physical function (25/31) - 78.6% of studies measuring pain (11/14) - 73.3% of studies measuring fatigue (11/15) - 55.6% of studies measuring depression or anxiety (5/9)
Why it matters
This review documents the heavy functional and quality-of-life burden imposed by cancer cachexia across solid tumor types, providing a basis for selecting standardized, patient-relevant functional endpoints in future clinical trials.
Limits
The underlying evidence base is overwhelmingly observational (94.6%), precluding causal determinations. Eleven of 19 reported outcome types were assessed only through univariate analysis without controlling for potential confounders. Substantial heterogeneity in diagnostic criteria (11 definitions) and assessment tools prevented quantitative meta-analysis.
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