# Clinical validation of AWGC-defined cachexia in gastric cancer patients: impact on body composition and quality of life

## TL;DR

This study validates the AWGC criteria for cachexia in gastric cancer patients, showing it is linked to worse body composition and quality of life.

## Contribution

The study provides clinical validation of AWGC-defined cachexia in gastric cancer patients and highlights its unique impact on quality of life.

## Key findings

- AWGC-defined cachexia is associated with lower skeletal and fat muscle indices compared to non-cachexia patients.
- AWGC-defined cachexia is independently linked to significantly worse health-related quality of life.
- Moderate agreement exists between AWGC and Fearon’s criteria for diagnosing cachexia in gastric cancer patients.

## Abstract

The Asian Working Group for Cachexia (AWGC) has released consensus criteria for diagnosing cachexia in Asians. Nevertheless, there is limited data regarding the application of these criteria in cancer patients. This study aimed to assess the changes in body composition and quality of life in gastric cancer (GC) patients with cachexia defined by the AWGC criteria.

Body composition parameters were analyzed using CT images at the level of the third lumbar vertebra. The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30) was used to evaluate health-related quality of life (HRQoL). The diagnosis of cachexia was according to the AWGC criteria and Fearon’s criteria.

A total of 431 patients with GC was included in this study. Among them, 160 patients (37.1%) were diagnosed with cachexia according to the AWGC criteria and 166 patients (38.5%) were diagnosed with cachexia based on the Fearon’s criteria. The agreement between the two criteria for diagnosing cachexia was moderate (k = 0.477, p < 0.001). Patients with AWGC-cachexia had significantly lower skeletal muscle index (SMI), visceral fat index (VFI), and subcutaneous fat index (SFI) compared to those without (p < 0.001). The prevalence of poor HRQoL was notably higher in patients with AWGC-defined cachexia (78.12% vs. 33.21%, p < 0.001). Furthermore, AWGC-defined cachexia was independently associated with poor HRQoL (OR = 5.92, 95% CI: 3.27–10.73; p < 0.001), while Fearon-defined cachexia did not show such an association (OR = 1.51, 95% CI: 0.86–2.65; p = 0.154).

Patients with AWGC-defined cachexia showed significant changes in body composition and was independently associated with poor HRQoL.