Eating-related distress in cancer cachexia: multicentre self-reported questionnaire study.

OBJECTIVES

The Asian Working Group for Cachexia (AWGC) updated the diagnostic criteria for cachexia, emphasising its multidimensional influence. We hypothesised that patients meeting the AWGC criteria would exhibit higher levels of eating-related distress (ERD) than those meeting the European Palliative Care Research Collaborative (EPCRC) criteria.

METHODS

A multicentre survey using a self-reported questionnaire was conducted between November 2023 and June 2024 among adult patients with advanced cancer. We evaluated ERD using the Questionnaire for Eating-Related Distress in Patients with Advanced Cancer (QERD-P). Cachexia was diagnosed using both AWGC and EPCRC criteria, examining their relationship with ERD using multiple linear regression models.

RESULTS

Among 192 patients analysed, the prevalence of cachexia was 74% according to AWGC and 64% according to EPCRC criteria. Anorexia scores were significantly associated with the presence of AWGC-defined cachexia but not EPCRC-defined cachexia (p<0.001, 0.177, respectively). Both AWGC-defined and EPCRC-defined cachexia showed significant associations with the total score of the QERD-P long version in simple linear regression models (p<0.001 and p=0.011, respectively); however, after adjusting for covariates, including age, sex, dietary intake, performance status, primary cancer site and treatment status, the total score of QERD-P long version was significantly higher only in AWGC-defined criteria group but not in EPCRC-defined cachexia group (p=0.020, 0.095, respectively).

CONCLUSIONS

AWGC-defined cachexia showed a stronger association with ERD compared with EPCRC-defined cachexia, incorporating anorexia as a subjective symptom. AWGC criteria may better capture ERD-related aspects of cachexia, requiring further validation.