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Clinical significance of weight changes at diagnosis in solid tumours

  • Niamh O’Donoghue
  • Shiva Shrotriya
  • Aynur Aktas
  • Barbara Hullihen
  • Serkan Ayvaz
  • Bassam Estfan
  • Declan Walsh
Original Article
  • 65 Downloads

Abstract

Purpose

Weight changes occur throughout the cancer trajectory. Most research has focused on changes during or after treatment, so clinical significance of change at diagnosis remains unclear. This study aimed to determine prevalence, predictors and prognostic significance of weight changes at diagnosis in outpatients with solid tumours presenting to a tertiary academic medical centre.

Methods

A retrospective study of the electronic medical record was conducted (n = 6477). Those with weight recorded within 6 months of cancer diagnosis (pre-diagnosis, T0) and 2 subsequent weights (diagnosis, T1; final visit, T2) were identified (n = 4258). Percentage weight change was categorised into four bands (0.1–2.4%; 2.5–5%; 5.01–9.9%; ≥ 10%) for gain and loss. A stable category was also included.

Results

Mean age is 61 ± 12.5 years. Common tumour sites: breast (17%; n = 725), prostate (16%; n = 664), lung (14%; n = 599). 15% (n = 652) had metastatic disease at T1. 98% (n = 4159) had weight change at T1. Head & neck and upper gastrointestinal cancers were significantly associated with weight loss (p < 0.001). Worst survival occurred with ≥ 10% weight gain or ≥ 10% weight loss. Overweight or obese body mass index with any percentage weight change band was associated with better overall survival.

Conclusions

Most had evidence of clinically significant weight changes at diagnosis. Weight loss at diagnosis was associated with a higher risk of further weight loss. A detailed weight history at cancer diagnosis is essential to identify and intervene for those most at risk of weight change-related early mortality.

Keywords

Cancer Prognosis Survival Weight gain Weight loss 

Notes

Acknowledgments

We would like to thank Katy Tobin, PhD, Assistant Professor of Biostatistics, Trinity College Dublin and Siobhan Scarlett, Data Manager, The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin for their assistance with statistical analysis.

Compliance with ethical standards

Ethical approval

Institutional Review Board approval was granted for this study.

Informed consent

This study met the criteria for waiver of informed consent.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.School of MedicineTrinity College DublinDublinIreland
  2. 2.Academic Department of Palliative Medicine, Education & Research CentreOur Lady’s Hospice & Care ServicesDublinIreland
  3. 3.Department of Solid Tumor OncologyCleveland Clinic Taussig Cancer InstituteClevelandUSA
  4. 4.The Harry R. Horvitz Center for Palliative MedicineCleveland Clinic Taussig Cancer InstituteClevelandUSA
  5. 5.Department of ITD Analytics eResearchThe Cleveland Clinic FoundationClevelandUSA

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