Aplicabilidade do Weight Loss Grading System (WLGS) na avaliação da caquexia e sobrevida em pacientes com câncer avançado

Abstract

Introduction: Advanced cancer represents a major challenge in oncologic care due to clinical complications that impair functionality and worsen patients' overall condition. In this context, cancer cachexia, a multifactorial and progressive syndrome characterized by involuntary weight loss and systemic inflammation that leads to a decline in nutritional status and negatively affects prognosis. Given the lack of simple and effective tools for cachexia staging and clinical risk stratification, the Weight Loss Grading System (WLGS) has emerged as a promising alternative. Objective: This prospective study aimed to evaluate the applicability of the WLGS in predicting cachexia stages and estimating survival in patients with advanced cancer. Methods: The study was conducted from 2021 to 2024 at the Hospital das Clínicas of the Federal University of Uberlândia and included 100 patients with advanced cancer receiving palliative care. Sociodemographic, clinical, and anthropometric data were collected, and the WLGS was applied. The association between WLGS and cachexia stages was analyzed using Pearson’s chi-square test. Median survival across WLGS categories was estimated using the Kaplan–Meier method, and mortality prediction was assessed using binary logistic regression. Results: A significant association of the WLGS with cachexia stages was found, with more advanced stages of the syndrome being associated with higher grades of the system (p < 0.001). The WLGS was identified as an independent predictor of 180-day mortality (OR = 1.374; p = 0.038), indicating an approximately 37.4% increase in the risk of death for each additional point in the system. Furthermore, median survival decreased with increasing WLGS scores, with significant differences observed between the Grade 0 and Grade 4 groups (p < 0.049). Conclusion: These findings suggest that the WLGS is a valuable tool for risk stratification in patients with advanced cancer, as it is associated with both the severity of cachexia and overall survival. Its integration into clinical practice may support more personalized and effective interventions.