{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T06:11:36Z","timestamp":1792649496050,"version":"4.5.0"},"reference-count":56,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2005,4,8]],"date-time":"2005-04-08T00:00:00Z","timestamp":1112918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2005,5,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Several investigations that yielded different results in terms of net changes in body composition of weight\u2010losing cancer patients have been reported that employed a variety of methods based on fundamentally different technology. Most of those reports were cross\u2010sectional, whereas to the authors' knowledge there is sparse information available on longitudinal follow\u2010up measurements in relation to other independent methods for the assessment of metabolism and performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>For the current report, the authors evaluated time course changes in body composition (dual\u2010energy X\u2010ray absorptiometry) with measurements of whole body and regional distribution of fat and lean tissue in relation to food and dietary intake, host metabolism (indirect calorimetry), maximum exercise capacity (walking test), and circulating hormones in cancer patients who were receiving palliative care during 4\u201362 months of follow\u2010up. The entire cohort comprised 311 patients, ages 68 years \u00b1 3 years who were diagnosed with solid gastrointestinal tumors (84 colorectal tumors, 74 pancreatic tumors, 73 upper gastrointestinal tumors, 51 liver\u2010biliary tumors, 3 breast tumors, 5 melanomas, and 21 other tumor types).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Decreased body weight was explained by loss of body fat, preferentially from the trunk, followed by leg tissue and arm tissue, respectively. Lean tissue (fat\u2010free mass) was lost from arm tissue, whereas trunk and leg tissue compartments increased, all concomitant with declines in serum albumin, increased systemic inflammation (C\u2010reactive protein, erythrocyte sedimentation rate), increased serum insulin, and elevated daily caloric intake; whereas serum insulin\u2010like growth factor 1 (IGF\u20101), resting energy expenditure, and maximum exercise capacity remained unchanged in the same patients. Serum albumin levels (<jats:italic>P<\/jats:italic> &lt; 0.001), whole body fat (<jats:italic>P<\/jats:italic> &lt; 0.02), and caloric intake (<jats:italic>P<\/jats:italic> &lt; 0.001) predicted survival, whereas lean tissue mass did not. Daily intake of fat and carbohydrate was more important for predicting survival than protein intake. Survival also was predicted by serum IGF\u20101, insulin, leptin, and ghrelin levels (<jats:italic>P<\/jats:italic> &lt; 0.02 \u2013 <jats:italic>P<\/jats:italic> &lt; 0.001). Serum insulin, leptin, and ghrelin (total) levels predicted body fat (<jats:italic>P<\/jats:italic> &lt; 0.001), whereas IGF\u20101 and thyroid hormone levels (T<jats:sub>3<\/jats:sub>, free T<jats:sub>3<\/jats:sub>) predicted lean tissue mass (<jats:italic>P<\/jats:italic> &lt; 0.01). Systemic inflammation primarily explained variation in lean tissue and secondarily explained loss in body fat. Depletion of lean arm tissue was related most to short survival compared with the depletion of lean leg and trunk tissue.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The current results demonstrated that body fat was lost more rapidly than lean tissue in progressive cancer cachexia, a phenomenon that was related highly to alterations in the levels of circulating classic hormones and food intake, including both caloric amount and diet composition. The results showed importance in the planning of efficient palliative treatment for cancer patients. Cancer 2005. \u00a9 2005 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.21013","type":"journal-article","created":{"date-parts":[[2005,4,8]],"date-time":"2005-04-08T12:48:12Z","timestamp":1112964492000},"page":"2189-2198","source":"Crossref","is-referenced-by-count":266,"title":["Body composition and time course changes in regional distribution of fat and lean tissue in unselected cancer patients on palliative care\u2014Correlations with food intake, metabolism, exercise capacity, and 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