{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:49:09Z","timestamp":1787507349716,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"22","license":[{"start":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T00:00:00Z","timestamp":1763510400000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Cancer cachexia is a multifactorial syndrome characterized by progressive weight loss, muscle wasting, and systemic inflammation. Early identification of individuals at risk for cachexia is essential for timely intervention, yet a universally accepted definition of the \u201cat risk\u201d stage remains lacking. Building on the Asian Working Group for Cachexia (AWGC) framework, we propose that the presence of any one of the five components\u2014low BMI (&lt;\u200921\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ), weight loss \u2265\u20092% over 3\u20136\u2009months, anorexia, low handgrip strength, or elevated CRP levels\u2014may indicate vulnerability to cachexia. We evaluated the prognostic value of this definition in a cohort of 364 patients with palliative cancer. The patients were categorized into three groups: non\u2010cachectic, at risk, and cachectic. Survival analyses demonstrated significant differences across groups (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005), with the median overall survival not reached in the non\u2010cachectic group, 381\u2009days in the at\u2010risk group, and 157\u2009days in the cachectic group. While low BMI and weight loss were not associated with survival in patients with edema, they became evident in those without edema (HR\u2009=\u20091.54 and 1.58), highlighting the confounding role of fluid retention in anthropometric assessment. Anorexia, low handgrip strength, and elevated CRP levels independently predicted poor prognosis in both full and non\u2010edematous cohorts. These findings support the clinical relevance of an \u201cat risk\u201d category based on AWGC components, especially in patients without edema. This simple and pragmatic definition may facilitate the early identification of patients who could benefit from supportive interventions before cachexia becomes refractory.\n                  <\/jats:p>","DOI":"10.1111\/1759-7714.70188","type":"journal-article","created":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T06:34:48Z","timestamp":1763620488000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Revisiting Cancer Cachexia Staging: Introducing an \u201cAt Risk\u201d Category Based on\n                    <scp>AWGC<\/scp>\n                    Components"],"prefix":"10.1111","volume":"16","author":[{"given":"Tatsuma","family":"Sakaguchi","sequence":"first","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Kansai Medical University  Hirakata Osaka Japan"},{"name":"Department of Surgery Kansai Medical University Kori Hospital  Neyagawa Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7132-7818","authenticated-orcid":false,"given":"Keisuke","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University  Nagakute Aichi Japan"},{"name":"Nutrition Therapy Support Center Aichi Medical University Hospital  Nagakute Aichi Japan"},{"name":"Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology  Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Yamasaki","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Kansai Medical University  Hirakata Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoharu","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Medicine, Graduate School of Medicine Aichi Medical University  Nagakute Aichi Japan"},{"name":"Palliative Care Center Aichi Medical University  Nagakute Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,19]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2008.06.013"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmaa111"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70218-7"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1759\u20107714.15503"},{"key":"e_1_2_17_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12351"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.02.005"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/esmoopen-2018-000345"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-22-561"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31128"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00558-6"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.02.017"},{"key":"e_1_2_17_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/2162402X.2021.1950411"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13384"},{"key":"e_1_2_17_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13323"},{"key":"e_1_2_17_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13408"},{"key":"e_1_2_17_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2024.02.026"},{"key":"e_1_2_17_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2019.01.011"},{"key":"e_1_2_17_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2023.112152"},{"key":"e_1_2_17_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.56.1894"},{"key":"e_1_2_17_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13287"},{"key":"e_1_2_17_22_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0224540"},{"key":"e_1_2_17_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-008-0447-8"},{"key":"e_1_2_17_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2024.10.162"},{"key":"e_1_2_17_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-013-1894-4"},{"key":"e_1_2_17_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0884533617700862"},{"key":"e_1_2_17_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12614"},{"key":"e_1_2_17_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012"},{"key":"e_1_2_17_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2015.11.025"},{"key":"e_1_2_17_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12184"},{"key":"e_1_2_17_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/082585979100700202"},{"key":"e_1_2_17_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2022.12.013"},{"key":"e_1_2_17_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyad177"},{"key":"e_1_2_17_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCO.0000000000000815"}],"container-title":["Thoracic 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