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ORIGINAL RESEARCH article

Front. Nutr.

Sec. Clinical Nutrition

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1659669

Clinical validation of AWGC-defined cachexia in gastric cancer patients: impact on body composition and quality of life

Provisionally accepted
Yan  HuangYan HuangXi  WuXi WuYan  GeYan GeChen  WangChen WangXin  DingXin DingJunbo  ZuoJunbo Zuo*
  • Jiangsu University, Zhenjiang, China

The final, formatted version of the article will be published soon.

Background: The Asian Working Group for Cachexia (AWGC) has released consensus criteria for diagnosing cachexia in Asians. Nevertheless, there is limited data regarding the application of these criteria in cancer patients. This study aimed to assess the changes in body composition and quality of life in gastric cancer (GC) patients with cachexia defined by the AWGC criteria. Methods: Body composition parameters were analyzed using CT images at the level of the third lumbar vertebra. The European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire-Core 30 (EORTC QLQ-C30) was used to evaluate health-related quality of life (HRQoL). The diagnosis of cachexia was according to the AWGC criteria and Fearon's criteria. Results: A total of 431 patients with GC was included in this study. Among them, 160 patients (37.1%) were diagnosed with cachexia according to the AWGC criteria and 166 patients (38.5%) were diagnosed with cachexia based on the Fearon's criteria. The agreement between the two criteria for diagnosing cachexia was moderate (k = 0.477, p < 0.001). Patients with AWGC-cachexia had significantly lower skeletal muscle index (SMI), visceral fat index (VFI), and subcutaneous fat index (SFI) compared to those without (p < 0.001). The prevalence of poor HRQoL was notably higher in patients with AWGC-defined cachexia (78.12% vs. 33.21%, p < 0.001). Furthermore, AWGC-defined cachexia was independently associated with poor HRQoL (OR = 5.92, 95% CI: 3.27-10.73; p < 0.001), while Fearon-defined cachexia did not show such an association (OR = 1.51, 95% CI: 0.86 - 2.65; p = 0.154). Conclusions: Patients with AWGC-defined cachexia showed significant changes in body composition and was independently associated with poor HRQoL.

Keywords: Cancer cachexia, the Asian Working Group for Cachexia, Body Composition, Quality of Life, gastric cancer

Received: 04 Jul 2025; Accepted: 13 Oct 2025.

Copyright: © 2025 Huang, Wu, Ge, Wang, Ding and Zuo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Junbo Zuo, zuojunbo88@hotmail.com

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