Supplementary material

Table S1

Evaluable patients at each time point

Time point / Total No. of patients / No. of patients evaluable for skeletal muscle mass / No. of patients evaluable for cancer cachexia
T1 (Baseline) / 134 / 130
(M=4) / 79
(W=55)
T2 (3 mo) / 130
(D=4) / 121
(M=9) / 115
(W=15)
T3 (6 mo) / 116
(D=12, C=2) / 105
(M=11) / 98
(W=18)
T4 (12 mo) / 87
(D=25, C=4) / 78
(M=9) / 73
(W=14)

D: number of patients who died during the interval period from the prior time point, C: number of patients who were censored due to transferring to another hospital or drop out during the interval period from the prior time point, M: number of patients who had missing data of skeletal muscle mass at the time point due to absence of CT sample or technical problem in measuring muscle mass, W: number of patients with missing value in their weight at required time point that was needed for diagnosing cachexia or non-cachexia.

Table S2

Baseline LSMI and prognosis

LSMI level (cm2/m2) / Men / Women
HR (95% CI) / P-value / HR (95% CI) / P-value
37 / 0.32 (0.15-0.79) / 0.0163 / 0.51 (0.24-1.05) / 0.0684
38 / 0.41 (0.22-0.83) / 0.0159 / 0.38 (0.15-0.83) / 0.0138 b
39 / 0.44 (0.24-0.86) / 0.0187 / 0.68 (0.27-1.50) / 0.3586
40 / 0.44 (0.25-0.82) / 0.0115 / 0.70 (0.26-1.60) / 0.4122
41 / 0.45 (0.26-0.81) / 0.0095 a / 0.78 (0.29-1.81) / 0.5873
42 / 0.61 (0.36-1.10) / 0.0994 / 0.42 (0.07-1.39) / 0.1730
43 / 0.63 (0.38-1.06) / 0.0826 / 0.38 (0.02-1.78) / 0.2646
44 / 0.62 (0.38-1.04) / 0.0675 / 0.54 (0.03-2.52) / 0.4988

a: most lowest P-value in men at 41 cm2/m2 of LSMI

b: most lowest P-value in women at 38 cm2/m2 of LSMI

LSMI: lumbar skeletal muscle index, HR: hazard ratio, CI: confidence interval

Table S3

Prognostic impact of conversion in cachexia status

Cachexia status:
T1 (Baseline)
→T2 (after 3 mo) / N = 68a / OS from T2
(months) / Adjusted hazard ratio
(95% CI)b / P-value
Non-CC → Non-CC b / 28 / 31.1 / Reference
Non-CC → CC / 8 / 13.8 / 1.59 (0.53 - 4.35) / 0.3923
CC → Non-CC / 14 / 17.8 / 2.39 (0.93 - 6.23) / 0.0699
CC → CC / 18 / 8.3 / 4.28 (1.86 – 10.20) / 0.0006

a) A total of 68 Patients without missing values at both time points were included.

b) CC at T2 was diagnosed if the patient had weight loss of greater than 5% as compared with baseline value or greater than 2% loss of weight with BMI of lower than 20 kg/m2 at T2.

c) Cox proportional hazard ratios were adjusted for ECOG-PS at T2 point, gender, and best response.

CC: cancer cachexia, OS: overall survival, CI: confidence interval

Table S4

Relationship among cachexia status, weight, skeletal muscle mass, chemotherapy-induced anorexia, and response rate

Cachexia status / N / Weight change (mean±SE, kg) a / P-value b / LSMI change (mean±SE, kg) a / P-value b / ≥Gr2 CIA (%) / RR (%)
Non-CC
→ Non-CC / 28 / +0.50±0.33 / 0.3399 / -0.86±0.58 / 0.0594 / 21.4 / 39.3
Non-CC
→ CC / 8 / -2.77±0.80 / 0.0078 / -4.05±0.36 / 0.0078 / 37.5 / 62.5
CC
→ Non-CC / 14 / +1.49±0.57 / 0.0245 / -0.58±0.39 / 0.1726 / 7.1 / 28.6
CC
→ CC / 18 / -2.86±0.60 / <0.0001 / -2.45±0.63 / 0.0021 / 22.2 / 22.2

a) Mean change was calculated with the following formula: (value at T2 - baseline value); negative values indicate loss.

b) Wilcoxon's signed-rank test

CC: cancer cachexia, SE: standard error, CIA: chemotherapy-induced anorexia, RR: response rate