AB016. Intracranial tumor characteristics and the incidence of cachexia: a cross-sectional study

Background: Intracranial tumors constitute a significant burden on global morbidity and disability, posing a risk for the development of cachexia. Cancer cachexia is a multi-organ syndrome of systemic inflammation and negative energy balance which may lead to diminished treatment efficacy and reduced survival rates. The association between intracranial tumor features and incidence of cachexia remains unknown. The purpose of this study is to investigate the association between the characteristics of intracranial tumors and the incidence of cachexia in patients.

Methods: We conducted a retrospective cross-sectional study to observe hospitalized intracranial tumor patients at Dr. Cipto Mangunkusumo Hospital. This study described the prevalence and the percentage of baseline characteristics, the diagnosis of cachexia was based on Evans criteria. Kolmogorov-Smirnov for the normality test. Bivariate analysis was done using the Chi-square test for qualified categorical variables, the Fischer test for unqualified categorical variables, and the Mann-Whitney test for ordinal variables.

Results: Our study revealed of 36 subjects with intracranial tumor diagnosis, the incidence of cachexia was higher in secondary brain tumors compared to primary brain tumors [odds ratio (OR) 5.5; 95% confidence interval (CI): 1.28–23.69; P=0.02]. Cancer cachexia occurs through inflammation, autonomic, and neuroendocrine pathways, leading to increased energy expenditure and decreased energy intake. The burden of secondary brain tumor amplifies the overall metabolic demands and systemic inflammation thus contributing to cachexia progression, which is identified by significant weight loss in patients with secondary brain tumor groups compared to primary tumors (P=0.01). Patients with cachexia tend to experience malnutrition and fatigue (P=0.04), which may interfere with their survival rates and quality of life. The most common neurological deficit observed in our subjects is headache (72.2%), while patients presenting with clinical manifestations of extremity weakness were more likely to develop cachexia (OR 6.4; 95% CI: 1.23–35.44; P=0.04). There were no significant differences in age distribution, gender, and brain tumor location among the subject groups.

Conclusions: Patients with secondary brain tumors and extremity weakness are more likely to develop cachexia. The severity of cachexia can help distinguish between primary and secondary brain tumors. Clinicians should pay attention to neurological deficits, particularly extremity weakness, as it can worsen cachexia.

Keywords: Cachexia; intracranial tumor; tumor characteristics