Weight loss in solid tumors: Clinical features and prognostic importance.

Abstract

e20572 Background: Large cancer databases provide valuable information on weight change and its impact on different clinical parameters. Body weight change in adults with solid tumors was examined in outpatients. The objective was to determine if demographics, clinical and biochemical indices are predictive of weight loss (WL). The effect of WL and other parameters on survival were also assessed. Methods: Electronic medical records (EMR) for outpatient visits from a tertiary cancer center were retrospectively reviewed. Body weight and other clinical parameters on first visit (V1) - within a year post diagnosis - last visit (V2) ≥3 weeks after V1. WL at V2 from V1 categorized as: ≤5%, 5.01-10%, >10%. Results summarized by descriptive statistics, level of association and survival analysis. Results: N = 5901; Mean age (±SD): 61 ± 12 years; 82% were Caucasians; 16% African Americans. Common cancers were genitourinary (GU) 31%; gastrointestinal (GI) 16%; breast 15%; lung 15%; head and neck 6%; brain 5% and others 12%. Metastatic disease in 18%. Bone, brain, lymph nodes – common. 45% had radiotherapy and 41% chemotherapy. Median (min, max) weight, kgs: V1=81(32.0, 223), V2=79.4(34, 221). Median duration (min, max), days V1→V2: 195 (22, 1080). Weight loss V1→V2: ≤5% (73%), 5.01-10% (13%) and >10% (14%). Median change in BMI V1→V2: -0.2 (-19, 13). Median change systolic/diastolic blood pressure (BP) V1→V2: -3(-99, 80)/-1(-57, 47). Change in REE V1→V2: -13(-890, 365). Median survival for 5.01-10.0% WL= 9.4 months, >10.0% = 5.3 months and not observed for ≤ 5%. Conclusions: Majority lost ≤ 5% of body weight by V2. WL maximum for head and neck cancer and GI. High BMI predicted greater WL compared to normal or underweight. ≤5% WL had a survival advantage 5.01-10% and >10%. WL remained prognostic for survival even after adjusting for other prognostic factors.