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Fluid retention and weight loss in refractory cancer cachexia
  1. Koji Amano1,2,
  2. Satomi Okamura3,
  3. Vickie Baracos4,
  4. Naoharu Mori5,
  5. Tatsuma Sakaguchi5,
  6. Yu Uneno6,
  7. Yusuke Hiratsuka7,
  8. Jun Hamano8,
  9. Tomofumi Miura9,
  10. Hiroto Ishiki10,
  11. Naosuke Yokomichi11,
  12. Yutaka Hatano12,
  13. Tatsuya Morita11 and
  14. Masanori Mori11
  15. The East-Asian collaborative cross-cultural Study to Elucidate the Dying process (EASED) investigators
    1. 1 Palliative and Supportive Care Center, Osaka University Hospital, Suita, Japan
    2. 2 Department of Psycho-Oncology and Palliative Medicine, Osaka International Cancer Institute, Osaka, Japan
    3. 3 Department of Medical Innovation, Osaka University Hospital, Suita, Japan
    4. 4 Department of Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
    5. 5 Department of Palliative and Supportive Medicine, Aichi Medical University, Nagakute, Japan
    6. 6 Department of Therapeutic Oncology, Kyoto University, Kyoto, Japan
    7. 7 Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
    8. 8 Department of Palliative and Supportive Care, University of Tsukuba, Tsukuba, Japan
    9. 9 Department of Palliative Medicine, National Cancer Center-Hospital East, Kashiwa, Japan
    10. 10 Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
    11. 11 Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
    12. 12 Department of Palliative Care, Daini Kyoritsu Hospital, Kawanishi, Japan
    1. Correspondence to Dr Koji Amano; kojiamano4813{at}gmail.com

    Abstract

    Objectives It is unknown to what extent the fluid retention (FR) status disrupts the detection of weight loss rate (WLR) in adult patients with advanced cancer. This study aimed to determine the association of FR status with WLR.

    Methods This study was a secondary analysis of a prospective cohort study. FR was evaluated as follows: oedema (0, no; 1, yes), pleural effusion (0, no; 1, yes but asymptomatic; 2, symptomatic) and ascites (0, no; 1, yes but asymptomatic; 2, symptomatic). Patients were divided into three groups according to their FR scores: no-FR (0), moderate-FR (1–2) and high-FR (3–5). Multiple regression analysis was performed.

    Results Four hundred and twenty patients were categorised: no-FR group (n=164), moderate-FR group (n=158) and high-FR group (n=98). The prevalence of oedema, pleural effusion and ascites was 63.9%, 27.8% and 36.7% in the moderate-FR group, and 93.9%, 61.3% and 82.6% in high-FR group. The means of WLR were 9.2, 8.4 and 3.8 in the groups. The high-FR group and the FR score of 5 were correlated with WLR (estimate −4.71, 95% CI −7.84 to –1.58; estimate −10.29, 95% CI −17.84 to –2.74).

    Conclusions The coexistence of FR was significantly correlated with WLR.

    • Cancer
    • Cachexia

    https://doi.org/10.1136/spcare-2024-004820

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      Footnotes

      • Collaborators Satoshi Inoue (Seirei Hospice, Seirei Mikatahara General Hospital), Kengo Imai (Seirei Hospice, Seirei Mikatahara General Hospital), Hiroaki Tsukuura (Department of Palliative Care, TUMS Urayasu Hospital), Toshihiro Yamauchi (Seirei Hospice, Seirei Mikatahara General Hospital), Akemi Shirado Naito (Department of palliative care Miyazaki Medical Association Hospital), Akira Yoshioka (Department of Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital), Shuji Hiramoto (Department of Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital), Ayako Kikuchi (Department of Oncology and Palliative Medicine, Mitsubishi Kyoto Hospital), Tetsuo Hori (Department of Respiratory surgery, Mitsubishi Kyoto Hospital), Yosuke Matsuda (Palliative Care Department, St.Luke's International Hospital), Hiroyuki Kohara (Hiroshima Prefectural Hospital), Hiromi Funaki (Hiroshima Prefectural Hospital), Keiko Tanaka (Department of Palliative Care Tokyo Metropolitan Cancer & Infectious Diseases Center Komagome Hospital), Kozue Suzuki (Department of Palliative Care Tokyo Metropolitan Cancer & Infectious Diseases Center Komagome Hospital), Tina Kamei (Department of Palliative Care, NTT Medical Center Tokyo), Yukari Azuma (Home Care Clinic Aozora Shin-Matsudo), Teruaki Uno (Department of Palliative Medicine, Osaka City General Hospital), Jiro Miyamoto (Department of Palliative Medicine, Osaka City General Hospital), Hirofumi Katayama (Department of Palliative Medicine, Osaka City General Hospital), Hideyuki Kashiwagi (Aso Iizuka Hospital/Transitional and Palliative Care), Eri Matsumoto (Aso Iizuka Hospital/Transitional and Palliative Care), Kiyofumi Oya (Aso Iizuka Hospital/Transitional and Palliative Care), Takeya Yamaguchi (Japan Community Health care Organization Kyushu Hospital/Palliative Care), Tomonao Okamura (Aso Iizuka Hospital/Transitional and Palliative Care), Hoshu Hashimoto (Inoue Hospital/Internal Medicine), Shunsuke Kosugi (Department of General Internal Medicine, Aso Iizuka Hospital), Nao Ikuta (Department of Emergency Medicine, Osaka Red Cross Hospital), Yaichiro Matsumoto (Department of Transitional and Palliative Care, Aso Iizuka Hospital), Takashi Ohmori (Department of Transitional and Palliative Care, Aso Iizuka Hospital), Takehiro Nakai (Immuno-Rheumatology Center, St Luke's International Hospital), Takashi Ikee (Department of Cardiorogy, Aso Iizuka Hospital), Yuto Unoki (Department of General Internal Medicine, Aso Iizuka Hospital), Kazuki Kitade (Department of Orthopedic Surgery, Saga-Ken Medical Centre Koseikan), Shu Koito (Department of General Internal Medicine, Aso Iizuka Hospital), Nanao Ishibashi (Environmental Health and Safety Division, Environmental Health Department, Ministry of the Environment), Masaya Ehara (TOSHIBA), Kosuke Kuwahara (Department of General Internal Medicine, Aso Iizuka Hospital), Shohei Ueno (Department of Hematology/Oncology, Japan Community Healthcare Organization Kyushu Hospital), Shunsuke Nakashima (Oshima Clinic), Yuta Ishiyama (Department of Transitional and Palliative Care, Aso Iizuka Hospital), Akihiro Sakashita (Department of Palliative Medicine, Kobe University School of Medicine), Ryo Matsunuma (Department of Palliative Medicine, Kobe University Graduate School of Medicine), Hana Takatsu (Division of Palliative Care, Konan Medical Center), Takashi Yamaguchi (Division of Palliative Care, Konan Medical Center), Satoko Ito (Hospice, The Japan Baptist Hospital), Toru Terabayashi (Hospice, The Japan Baptist Hospital), Jun Nakagawa (Hospice, The Japan Baptist Hospital), Tetsuya Yamagiwa (Hospice, The Japan Baptist Hospital), Akira Inoue (Department of Palliative Medicine Tohoku University School of Medicine), Takuhiro Yamaguchi (Professor of Biostatistics, Tohoku University Graduate School of Medicine), Mitsunori Miyashita (Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine), Saran Yoshida (Graduate School of Education, Tohoku University), Keita Tagami (Department of Palliative Medicine Tohoku University School of Medicine), Hiroaki Watanabe (Department of Palliative Care, Komaki City Hospital), Takuya Odagiri (Department of Palliative Care, Komaki City Hospital), Tetsuya Ito (Department of Palliative Care, Japanese Red Cross Medical Center), Masayuki Ikenaga (Hospice, Yodogawa Christian Hospital), Keiji Shimizu (Department of Palliative Care Internal Medicine, Osaka General Hospital of West Japan Railway Company), Akira Hayakawa (Hospice, Yodogawa Christian Hospital), Rena Kamura (Hospice, Yodogawa Christian Hospital), Takeru Okoshi (Okoshi Nagominomori Clinic), Isseki Maeda (Department of Palliative Care, Senri-Chuo Hospital), Tomohiro Nishi (Kawasaki Municipal Ida Hospital, Kawasaki Comprehensive Care Center), Kazuhiro Kosugi (Department of Palliative Medicine, National Cancer Center Hospital East), Yasuhiro Shibata (Kawasaki Municipal Ida Hospital, Kawasaki Comprehensive Care Center), Takayuki Hisanaga (Department of Palliative Medicine, Tsukuba Medical Center Hospital), Takahiro Higashibata (Department of General Medicine and Primary Care, Palliative Care Team, University of Tsukuba Hospital), Ritsuko Yabuki (Department of Palliative Medicine, Tsukuba Medical Center Hospital), Shingo Hagiwara (Department of Palliative Medicine, Yuai Memorial Hospital), Miho Shimokawa (Department of Palliative Medicine, Tsukuba Medical Center Hospital), Satoshi Miyake (Professor, Department of Clinical Oncology Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University (TMDU)), Junko Nozato (Specially Appointed Assistant Professor, Department of Internal Medicine, Palliative Care, Medical Hospital, Tokyo Medical and Dental University), Tetsuji Iriyama (Specially Appointed Assistant Professor, Department of Internal Medicine, Palliative Care, Medical Hospital, Tokyo Medical and Dental University), Keisuke Kaneishi (Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center), Mika Baba (Department of Palliative medicine Suita Tokushukai Hospital), Yoshihisa Matsumoto (Department of Palliative Medicine, National Cancer Center Hospital East), Ayumi Okizaki (Department of Palliative Medicine, National Cancer Center Hospital East), Yuki Sumazaki Watanabe (Department of Palliative Medicine, National Cancer Center Hospital East), Yuko Uehara (Department of Palliative Medicine, National Cancer Center Hospital East), Eriko Satomi (Department of palliative medicine, National Cancer Center Hospital), Kaoru Nishijima (Department of Palliative Medicine, Kobe University Graduate School of Medicine), Junichi Shimoinaba (Department of Hospice Palliative Care, Eikoh Hospital), Ryoichi Nakahori (Department of Palliative Care, Fukuoka Minato Home Medical Care Clinic), Takeshi Hirohashi (Eiju General Hospital), Natsuki Kawashima (Department of Palliative Medicine, Tsukuba Medical Center Hospital), Takashi Kawaguchi (Tokyo University of Pharmacy and Life Sciences Department of Practical Pharmacy), Megumi Uchida (Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences), Ko Sato (Hospice, Ise Municipal General Hospital), Yoichi Matsuda (Department of Anesthesiology & Intensive Care Medicine/Osaka University Graduate School of Medicine), Satoru Tsuneto (Professor, Department of Human Health Sciences, Graduate School of Medicine, Kyoto University Department of Palliative Medicine, Kyoto University Hospital), Sayaka Maeda (Department of Palliative Medicine, Kyoto University Hospital), Yoshiyuki Kizawa FJSIM, DSBPMJ (Designated Professor and Chair, Department of Palliative Medicine, Kobe University School of Medicine), Hiroyuki Otani (Palliative Care Team, and Palliative and Supportive Care, National Kyushu Cancer Center).

      • Contributors Conceptualisation: KA. Methodology: KA and SO. Software: SO. Validation: KA and SO. Formal analysis: SO. Investigation: KA, SO, VB, NM and TS. Resources: KA, YU, YHiratsuka, JH, TMiura, HI, NY, YHatano and MM. Data curation: KA, YU, YHiratsuka, JH, TMiura, HI, NY, YHatano and MM. Writing—original draft preparation: KA. Writing—review and editing: SO, VB, NM and TS. Visualisation: KA and SO. Supervision: TMorita. Project administration: TMorita and MM. Funding acquisition: TMorita. All authors have read and agreed to the published version of the manuscript.

      • Funding The present study was supported in part by a Grant-in-Aid from the Japan Hospice Palliative Care Foundation and JSPS KAKENHI Grant Number 22K11839.

      • Competing interests None declared.

      • Provenance and peer review Not commissioned; internally peer reviewed.

      • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.