{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:05:50Z","timestamp":1789398350509,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP 25K10065"],"award-info":[{"award-number":["JP 25K10065"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012834","name":"Gifu University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012834","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>Cachexia substantially affects the prognosis of patients with advanced cancer. While both the Asian Working Group for Cachexia (AWGC) and European Palliative Care Research Collaborative (EPCRC) criteria are widely used for diagnosis, their comparative effectiveness in diagnostic timing and prognostic value remain understudied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective study included patients with metastatic colorectal cancer (mCRC) who received first-line chemotherapy between 2013 and 2023. Cachexia was assessed using three distinct criteria: AWGC criteria, defined as either weight loss\u2009&gt;\u20092%, or body mass index (BMI)\u2009&lt;\u200921\u00a0kg\/m<jats:sup>2<\/jats:sup> accompanied by at least one of the following: anorexia or elevated C-reactive protein level; EPCRC criteria, requiring weight loss\u2009&gt;\u20095% (or weight loss\u2009&gt;\u20092% if BMI is\u2009&lt;\u200920); and Modified Glasgow Prognostic Score (mGPS). Analyses were performed using cumulative incidence and survival with a time-dependent Cox regression model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>We enrolled 313 patients with metastatic CRC. The 1-year cumulative incidence of cachexia showed marked variation across the different diagnostic criteria. Using the AWGC criteria, the incidence rate was 69%, whereas the EPCRC criteria identified 44% of the cases. The mGPS evaluation revealed incidence rates of 73% and 39% for scores of 1 and 2, respectively. Both AWGC- and EPCRC-defined cachexia correlated with significantly shorter overall survival (AWGC: hazard ratio (HR)\u2009=\u20092.41, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; EPCRC: HR\u2009=\u20092.02, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Similarly, the mGPS scores indicated a poor prognosis.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The AWGC criteria identified a higher incidence of cachexia earlier in the disease course compared to the EPCRC criteria and showed a stronger association with overall survival. The mGPS shows promise as an alternative diagnostic tool to traditional weight-based assessments. These findings suggest new opportunities for early diagnosis of cachexia and intervention strategies in patients with mCRC.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00384-025-04962-2","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T20:44:05Z","timestamp":1753476245000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Cancer cachexia onset and survival outcomes in metastatic colorectal cancer: Comparative assessment of the asian working group for cachexia and the European palliative care research collaborative criteria, and utility of modified glasgow prognostic score"],"prefix":"10.1007","volume":"40","author":[{"given":"Hironori","family":"Fujii","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misato","family":"Kani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daichi","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuto","family":"Miura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wakana","family":"Chikaishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse Yu","family":"Tajima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akitaka","family":"Makiyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunami","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Ohata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiemi","family":"Hirose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotoshi","family":"Iihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Kobayashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhisa","family":"Matsuhashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akio","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"issue":"2","key":"4962_CR1","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1007\/s13539-012-0087-1","volume":"4","author":"VC Vaughan","year":"2013","unstructured":"Vaughan VC, Martin P, Lewandowski PA (2013) Cancer cachexia: impact, mechanisms and emerging treatments. 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Ohata has received honoraria for lectures from AbbVie Inc., AstraZeneca, Chugai Pharmaceutical Co., Ltd., Daiichi Sankyo, Genmab, Sanofi.\u00a0R Kobayashi has received honoraria for lectures from TEIJIN Pharma, Astellas Pharma, Janssen Pharmaceutical K.K.\u00a0A Suzuki has received honoraria for lectures from Toa Eiyo, Asahi Kasei Pharma, Daiichi Sankyo, Pfizer, Eisai, Nippon Shinyaku, Kyowa Kirin, Tsumura, Towa Pharmaceutical, Nippon Kayaku, Mochida Pharmaceutical, EA Pharma, Yakult Honsha, Chugai Pharmaceutical; grants made to institution from Nippon Kayaku, Asahi Kasei Pharma, Chugai Pharm., Taiho Pharm., Daiichi Sankyo, Japan Blood Products Organization, Mochida Pharm., Sun Pharma.\u00a0N Matsuhashi has received honoraria for lectures from Abbott, Alfresa Pharma, AMCO Inc., Asahi Kasei Pharma, AstraZeneca, Bayer Yakuhin, Bristol-Myers Squibb, Chugai Pharm., Covidien Japan, Daiichi Sankyo, EA Pharma, Eisai, Eli Lilly Japan, Guardant Health Japan Corp, Gunze Medical Limited, Intuitive Surgical, Johnson & Johnson, Kaken Pharm., Kyowa Kirin, MC Medical, Merck Biopharma Japan, Miyarisan Pharm., MSD, Novartis, Olympus Marketing, Inc., Ono Pharm., Stryker, Taiho Pharm., TAKATA Pharm., Takeda Pharm., TERUMO, Tsumura, Viatris, Yakult Honsha, ZERIA Pharm.; grants made to institution from Asahi Kasei Pharma, Chugai Pharm., Covidien Japan, Daiichi Sankyo, Eisai, Eli Lilly Japan, EP\u2010CRSU, EPS Corporation, Johnson & Johnson, Kaken Pharm., Kyowa Kirin, MSD, Nippon Kayaku, Ono Pharm.\u00b8 Otsuka Pharm., ShiftZero K.K., Taiho Pharm., Toray Medical, Tsumura.\u00a0The other authors have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure statement"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"164"}}