Longitudinal study of weight, appetite, performance status, and inflammation in advanced gastrointestinal cancer

There is increasing evidence that, in most patients with advanced cancer, w eight loss is associated with an inflammatory response. To examine the temp oral relationship between weight loss, appetite, performance status, and th e inflammatory response, 50 patients with advanced gastrointestinal cancer with weight loss were observed for six weeks. Patients were grouped accordi ng to whether they had lost weight (>3%, n = 16), were weighs stable (<3% c hange, n = 25), or gained weight (>3%, n = 9). Ar baseline, the group that subsequently lost weight had lower albumin and higher C-reactive protein co ncentrations (p < 0.05). On follow-up, there was an increase in C-reactive protein concentration and reductions in triceps skinfold thickness and Karn ofsky performance status in the weight-losing group (p < 0.05). In contrast Karnofsky performance status was improved in the group that gained weight (p < 0.05). Over the six to eight weeks, there was a difference in the chan ges of triceps skinfold thickness (p < 0.05) and Karnofsky performance stat us (p < 0.01) between the two groups. These results suggest that loss or ga in of >2.5 kg over a six- to eight-week period is required to produce a sig nificant alteration in performance status in weight-losing patients with ga strointestinal cancer. Moreover, the results suggest that the presence of a n inflammatory response is associated with further weight loss and the dete rioration of performance status.