A Simple Score for Predicting Cancer Cachexia Status in Patients with Stage I–III Colorectal Cancer: Cancer Cachexia Score

Abstract Purpose: Cancer cachexia, a complex multifactorial syndrome associated with sarcopenia, negatively affects quality of life and survival in patients with several cancers. We aimed to develop a new score for cachexia assessment and evaluate its effectiveness in classification of patients undergoing radical resection for colorectal cancer. Methods: This study included 396 patients who underwent radical resection for Stage I–III colorectal cancer. To develop the Cancer Cachexia Score (CCS), we analyzed predictive factors of cachexia status related to the development of sarcopenia and incorporated significant factors into the score. We then evaluated the relationship between CCS and overall survival after radical resection for colorectal cancer. Results: As body mass index (P < 0.001), prognostic nutritional index (P = 0.005), and tumor volume (P < 0.001) were significantly associated with the development of sarcopenia, these factors were included in CCS. Using CCS, 221 (56 %), 98 (25 %), and 77 (19 %) patients were diagnosed with mild, moderate, and severe cancer cachexia, respectively. In multivariate analysis, severe CCS (P < 0.001), N stage 1–2 (P < 0.001), and occurrence of postoperative complications (P = 0.007) were independent predictors of disease-free survival. Age ≥ 65 years (P = 0.009), severe CCS (P < 0.001), and N stage 1–2 (P < 0.001) were independent predictors of overall survival. Conclusions: CCS may be a strong predictor of poor survival in patients with colorectal cancer, suggesting the usefulness of CCS in classifying patients according to their cachexia status and predicting postoperative prognosis.