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| Name | Class |
|---|---|
| French College of General Hospital Pneumologists (CPHG) | OTHER |
| French-Speaking Association of Supportive Care in Cancer (AFSOS) | UNKNOWN |
| ITEC Services | OTHER |
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The purpose of this study is to assess the frequency of cachexia and the management of cachexia and associated symptoms in a patient population with non-small cell lung cancer (NSCLC).
This is a cross-sectional, non-interventional, European (France and Belgium), multicentric prevalence study, conducted on a representative population of 500 patients with NSCLC, to assess the frequency and the management of cachexia and associated symptoms.
The study will be conducted in accordance with the professional code of ethics and the good epidemiological practices guidelines developed by the ADELF (the Association of French-Speaking Epidemiologists) and in accordance with the STROBE recommendations for the drafting of reports and publications related to the study.
The information will be collected during a single visit to the oncologist/lung specialist as part of the usual patient management of his/her lung cancer. The physician will explain the purpose of the study to the patient with an information form specific to the study and will inform him/her of the option to refuse or withdraw from participation. The patient information form in France or a specific consent form in Belgium will be signed by the patient and a copy will be given to him/her (the original will be kept by the physician).
This study does not require any additional specific data. Data will come from the medical file and from the routine disease management. Furthermore, the following self-completion questionnaires will be proposed to patients: Visual analogue scale for dietary intake (dietary intake VAS), assessment of the concerns associated with the anorexia/cachexia (Anorexia-Cachexia module of the Functional Assessment of Anorexia/Cachexia Therapy [FAACT] questionnaire), quality of life (EORTC QLQ-C30), and assessment of physical activity (IPAQ, International Physical Activity Questionnaire). Abdominal CT-scan, if available, will be collected for assessment of skeletal muscle mass index at L3.
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| Measure | Description | Time Frame |
|---|---|---|
| Frequency of Cachexia According to Modified Fearon Criteria | Percentage of NSCLC patients with a cachexia according to Fearon criteria modified for the stages of pre-cachexia and refractory cachexia in order to classify all the featured cases without ambiguity. A patient was considered to have cachexia if he/she had:
In the 3 cases defined above, patient should not have entered the refractory cachexia stage, which was defined as: ECOG performance score of 3 or 4 and a low survival expectancy as defined by Martin et al. (J Clin Oncol 2015) (BMI <20 kg/m² and weight loss ≥ 6%) or (20 ≤ BMI ≤ 21.9 kg/m² and weight loss ≥ 11%) or (22 kg/m² ≤ BMI and weight loss ≥ 15%). | Day1 |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of the Different Stages of Cachexia in the General NSCLC Population | Percentage of the different stages of cachexia at inclusion. The different stages of cachexia used the following classification:
|
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Inclusion Criteria:
Exclusion Criteria:
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Patient with non-small cell lung cancer (NSCLC) from outpatient visit, Day Hospital or in-patient hospitalization.
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| Name | Affiliation | Role |
|---|---|---|
| Luz Bobadilla, MD | Chugai Pharma France | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Chugai Pharma France | Paris | 92042 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21296615 | Background | Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, Davis M, Muscaritoli M, Ottery F, Radbruch L, Ravasco P, Walsh D, Wilcock A, Kaasa S, Baracos VE. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011 May;12(5):489-95. doi: 10.1016/S1470-2045(10)70218-7. Epub 2011 Feb 4. |
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539 patients were recruited. Among them, 5 did not meet the eligibility criteria, 1 withdrew his/her consent, 2 were excluded during the data review because the cancer histology was undefined.
The analysis population included 531 patients and among them 312 had skeletal muscle mass assessment.
56 oncologists, lung specialists or radiation oncologists treating patients with a malignant lung tumour have recruited patients from outpatient visit, day hospital or in-patient hospitalization in France and Belgium, between the 25th of July and the 31th of October 2016. Patients were recruited in a consecutive manner.
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| ID | Title | Description |
|---|---|---|
| FG000 | NSCLC Patient | Patients,18 years and older, with Non Small Cell Lung Cancer (NSCLC) regardless of the tumor stage and the treatment line |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
The baseline analysis population is composed of all included patients without major protocol deviation.
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| ID | Title | Description |
|---|---|---|
| BG000 | NSCLC Patient | Patients,18 years and older, with Non Small Cell Lung Cancer (NSCLC) regardless of the tumor stage and the treatment line |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Frequency of Cachexia According to Modified Fearon Criteria | Percentage of NSCLC patients with a cachexia according to Fearon criteria modified for the stages of pre-cachexia and refractory cachexia in order to classify all the featured cases without ambiguity. A patient was considered to have cachexia if he/she had:
In the 3 cases defined above, patient should not have entered the refractory cachexia stage, which was defined as: ECOG performance score of 3 or 4 and a low survival expectancy as defined by Martin et al. (J Clin Oncol 2015) (BMI <20 kg/m² and weight loss ≥ 6%) or (20 ≤ BMI ≤ 21.9 kg/m² and weight loss ≥ 11%) or (22 kg/m² ≤ BMI and weight loss ≥ 15%). | missing data for 84 patients | Posted | Count of Participants | Participants | Day1 |
|
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This is a non-interventional epidemiological study. No safety data was collected. No reporting of adverse reaction is expected in the study.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | No Safety Data Was Collected | This is a non-interventional epidemiological study. No reporting of adverse reaction is expected in the study. |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr Luz BOBADILLA, Medical Affairs Director | CHUGAI PHARMA FRANCE | +33 1 56 37 05 28 | bobadilla@chugai-pharm.fr |
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| ID | Term |
|---|---|
| D002289 | Carcinoma, Non-Small-Cell Lung |
| D002100 | Cachexia |
| D000855 | Anorexia |
| D044342 | Malnutrition |
| ID | Term |
|---|---|
| D002283 | Carcinoma, Bronchogenic |
| D001984 | Bronchial Neoplasms |
| D008175 | Lung Neoplasms |
| D012142 | Respiratory Tract Neoplasms |
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| Day 1 |
| Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Stage Associated With NSCLC. | Percentage of the different stages of cachexia at inclusion according to the NSCLC stage | Day 1 |
| Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Histology Associated With NSCLC. | Percentage of the different stages of cachexia according to the NSCLC histology | Day 1 |
| Frequency of Sarcopenia in the General NSCLC Patients With Cachexia | Percentage of patients with sarcopenia in the general NSCLC patients with cachexia | Day 1 |
| Frequency of Sarcopenia With no Clinical Significant Weight Loss in the General NSCLC Patients With Pre-cachexia | Percentage of patient with sarcopenia and no clinical significant weight loss (sarcopenia and WL< 2%) in the general NSCLC patients with pre-cachexia: | Day 1 |
| Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Molecular Abnormalities Associated With NSCLC. | Percentage of the different stages of cachexia according to the molecular abnormalities associated with NSCLC:
| Day 1 |
| Frequency of the Different Stages of Cachexia According to the Number of Treatments Received. | NSCLC patients. 84 patients with missing data | Day 1 |
| Frequency of the Different Stages of Cachexia According to the Types of Treatments Received. | Stage of cachexia at inclusion according to the type of treatments received (surgery, radiotherapy, chemotherapy, targeted therapies). | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Nutritional State | • Nutritional state according to the different stages of cachexia The variables used will be: serum albumin levels, serum pre-albumin levels, BMI and weight. | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Blood Glucose | Blood glucose abnormalities according to the different stages of cachexia at inclusion | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Loss of Appetite - Dietary Intake Visual Analog Scale | Dietary Intake Visual Analog Scale (Dietary intake VAS): The question "Could you indicate the amount you currently eat, placing a vertical mark on the line between "nothing at all" and "as usual"? ". Depending on the location of the patient mark on the scale, a score of between 0 ("nothing at all") and 10 ("as usual") will be allocated. | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Loss of Appetite - AC/S FAACT | Score of the 12-question AC/S module (Anorexia-Cachexia module) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire assessing anorexia and cachexia: the AC/S module of the FAACT questionnaire consists of 12 questions to assess over the last 7 days quality of life, related to anorexia or cachexia. The score ranges between 0 and 48, the higher the score, the higher the quality of life. | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - Neutrophil/Lymphocyte Ratio | neutrophil/lymphocyte ratio | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - CRP | CRP level | Day 1 |
| Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - Fibrinogen | fibrinogen level | Day 1 |
| Description of the Quality of Life Associated With the Different Stages of Cachexia. | Quality of life has been analysed using scores from the functional scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Core 30 items (EORTC QLQ-C30 questionnaire): score ranging from 0 (malfunction) to 100 (healthy level of functioning) for the following parameters : physical, role, cognitive, emotional and social scales | Day 1 |
| Description of the Level of Physical Activity Associated With the Different Stages of Cachexia. | Three levels of physical activity are defined:
Corresponds to one of the following 2 criteria:
| Day 1 |
| Number of Participants Receiving a Pharmacological Treatment for Cachexia or for Associated Symptoms | Pharmacological treatment of cachexia or associated symptoms: Yes / No | Day 1 |
| Number of Participants Receiving a Non-Pharmacological Treatment for Cachexia or for Associated Symptoms | Non-pharmacological treatment of cachexia or associated symptoms: Y/N | Day 1 |
| Number of Participants Receiving Systemic Corticosteroids, Anti-inflammatory Drugs, Omega 3 Fatty Acids Treatments | Treatments with systemic corticosteroids, anti-inflammatory drugs, Omega 3 fatty acids: Yes/No | Day 1 |
| Number of Participants With Diabetes Treatments | Diabetes treatments : Yes/No | Day 1 |
| Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Cachexia |
| Day 1 |
| Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Anorexia |
| Day 1 |
| Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Malnutrition |
| Day 1 |
| year |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Performance Status ECOG (Eastern Cooperative Oncology Group) | Evaluated by the Investigator during the patient visit (4=worst outcome) : 0 Fully active - Able to carry on all pre-disease performance without restriction.
| Count of Participants | Participants |
|
| Smoking status | Count of Participants | Participants |
|
| Histology type | Count of Participants | Participants |
|
| Molecular abnormalities | Missing data for 202 patients | Count of Participants | Participants |
|
| Tumor stages | TNM stage at the time of the visit was collected by the Investigator and classified as follow:
| Missing data for 27 patients | Count of Participants | Participants |
|
| Description |
|---|
| OG000 | NSCLC Patients With Cachexia | Patients,18 years and older, with Non Small Cell Lung Cancer (NSCLC) regardless of the tumor stage and the treatment line with a cachexia |
|
|
| Secondary | Frequency of the Different Stages of Cachexia in the General NSCLC Population | Percentage of the different stages of cachexia at inclusion. The different stages of cachexia used the following classification:
| Missing data for 84 patients | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Stage Associated With NSCLC. | Percentage of the different stages of cachexia at inclusion according to the NSCLC stage | Patients,18 years and older, with Non Small Cell Lung Cancer (NSCLC) Missing data for 81 patients | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Histology Associated With NSCLC. | Percentage of the different stages of cachexia according to the NSCLC histology | Patients,18 years and older, with Non Small Cell Lung Cancer (NSCLC) Missing data for 84 patients | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of Sarcopenia in the General NSCLC Patients With Cachexia | Percentage of patients with sarcopenia in the general NSCLC patients with cachexia | Population with no missing data for the 3 interest criteria defining the cachexia | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of Sarcopenia With no Clinical Significant Weight Loss in the General NSCLC Patients With Pre-cachexia | Percentage of patient with sarcopenia and no clinical significant weight loss (sarcopenia and WL< 2%) in the general NSCLC patients with pre-cachexia: | Population with no missing data for the 3 interest criteria defining the pre-cachexia | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of the Different Stages of Cachexia in the General NSCLC Population According to Molecular Abnormalities Associated With NSCLC. | Percentage of the different stages of cachexia according to the molecular abnormalities associated with NSCLC:
| NSCLC patients Overall number of patients analyzed for cachexia stage; 244 missing data. | Posted | Count of Participants | Participants | Day 1 |
|
|
|
|
| Secondary | Frequency of the Different Stages of Cachexia According to the Number of Treatments Received. | NSCLC patients. 84 patients with missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Frequency of the Different Stages of Cachexia According to the Types of Treatments Received. | Stage of cachexia at inclusion according to the type of treatments received (surgery, radiotherapy, chemotherapy, targeted therapies). | NSCLC patients. 101 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Nutritional State | • Nutritional state according to the different stages of cachexia The variables used will be: serum albumin levels, serum pre-albumin levels, BMI and weight. | NSCLC patients | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Blood Glucose | Blood glucose abnormalities according to the different stages of cachexia at inclusion | NSCLC patients 329 data missing | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Loss of Appetite - Dietary Intake Visual Analog Scale | Dietary Intake Visual Analog Scale (Dietary intake VAS): The question "Could you indicate the amount you currently eat, placing a vertical mark on the line between "nothing at all" and "as usual"? ". Depending on the location of the patient mark on the scale, a score of between 0 ("nothing at all") and 10 ("as usual") will be allocated. | NSCLC patients 12 missing data | Posted | Mean | Standard Deviation | score on a scale | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Loss of Appetite - AC/S FAACT | Score of the 12-question AC/S module (Anorexia-Cachexia module) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire assessing anorexia and cachexia: the AC/S module of the FAACT questionnaire consists of 12 questions to assess over the last 7 days quality of life, related to anorexia or cachexia. The score ranges between 0 and 48, the higher the score, the higher the quality of life. | NSCLC patients 9 missing data | Posted | Mean | Standard Deviation | score on a scale | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - Neutrophil/Lymphocyte Ratio | neutrophil/lymphocyte ratio | NSCLC patients 112 missing data | Posted | Median | Inter-Quartile Range | no unit (ratio) | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - CRP | CRP level | NSCLC patients 317 missing data | Posted | Median | Inter-Quartile Range | mg/L | Day 1 |
|
|
|
| Secondary | Description of the Clinical Signs/Symptoms Associated With the Different Stages of Cachexia: Inflammation Markers - Fibrinogen | fibrinogen level | NSCLC patients 387 missing data | Posted | Median | Inter-Quartile Range | g/L | Day 1 |
|
|
|
| Secondary | Description of the Quality of Life Associated With the Different Stages of Cachexia. | Quality of life has been analysed using scores from the functional scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire- Core 30 items (EORTC QLQ-C30 questionnaire): score ranging from 0 (malfunction) to 100 (healthy level of functioning) for the following parameters : physical, role, cognitive, emotional and social scales | NSCLC patients Physical scale: 16 missing data Role scale: 17 missing data Cognitive scale: 16 missing data Emotional scale: 16 missing data Social scale: 18 missing data | Posted | Mean | Standard Deviation | Scale score | Day 1 |
|
|
|
|
| Secondary | Description of the Level of Physical Activity Associated With the Different Stages of Cachexia. | Three levels of physical activity are defined:
Corresponds to one of the following 2 criteria:
| NSCLC patients 69 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Number of Participants Receiving a Pharmacological Treatment for Cachexia or for Associated Symptoms | Pharmacological treatment of cachexia or associated symptoms: Yes / No | NSCLC patients 225 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Number of Participants Receiving a Non-Pharmacological Treatment for Cachexia or for Associated Symptoms | Non-pharmacological treatment of cachexia or associated symptoms: Y/N | NLSCS patients with a nutritional consultation within 2 months before inclusion 1 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Number of Participants Receiving Systemic Corticosteroids, Anti-inflammatory Drugs, Omega 3 Fatty Acids Treatments | Treatments with systemic corticosteroids, anti-inflammatory drugs, Omega 3 fatty acids: Yes/No | NSCLC patients 11 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Number of Participants With Diabetes Treatments | Diabetes treatments : Yes/No | NSCLC patients 6 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Cachexia |
| NSCLC patients Cachexia according to Investigator: 4 missing data Cachexia according to Fearon criteria: 84 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Anorexia |
| NSCLC patients Anorexia according to Investigator: 3 missing data Anorexia according to VAS: 22 missing data Anorexia according to FAACT: 19 missing data Anorexia according to question 13 of QLQ-C30 questionnaire: 33 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| Secondary | Comparison of the Proportion of Patients With Cachexia, Anorexia and Malnutrition According to the Subjective Assessment of the Clinician and the Different Objective Assessment Criteria: Malnutrition |
| NSCLC patients Severe malnutrition according to Investigator: 15 missing data Severe malnutrition according to the HAS: 416 missing data | Posted | Count of Participants | Participants | Day 1 |
|
|
|
| 0 |
| 0 |
| 0 |
| 0 |
The Study may not be published by the Health Institution or the Investigator without the prior written consent of the Promoter who has to respond as soon as possible.
If the Investigator wishes to proceed with a publication or communication relating to the Study, the Promoter may, in the event that a serious and valid reason appears to require it, request that certain modifications be made. The modifications cannot in any way affect the scientific value of the publication.
| D013899 |
| Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D015431 | Weight Loss |
| D001836 | Body Weight Changes |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D013851 | Thinness |
| D012817 | Signs and Symptoms, Digestive |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| Refractory Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Chi-squared |
| 0.0008 |
| Other |
| Pre-Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Pre-Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Pre-Cachexia |
|
| Cachexia |
|
| Refractory Cachexia |
|
| Cachexia |
|
| Refractory cachexia |
|
|
| Pre-Cachexia |
|
|
| Cachexia |
|
|
| Refractory Cachexia |
|
|
Without refractory cachexia
| <0.0001 |
Without refractory cachexia |
| Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | <0.0001 | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | Without refractory cachexia | <0.0001 | Without refractory cachexia | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | 0.1085 | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | Without refractory cachexia | 0.0482 | Without refractory cachexia | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | <0.0001 | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | Without refractory cachexia | <0.0001 | Without refractory cachexia | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | <0.0001 | Other |
| Statistical analysis compares all cachexia stages. | Kruskal-Wallis | Without refractory cachexia | <0.0001 | Without refractory cachexia | Other |
| Moderate |
|
| High |
|