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M.A. Spruit



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    P2.08 - Locally Advanced Nsclc (ID 709)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Locally Advanced NSCLC
    • Presentations: 1
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      P2.08-001 - Hand Grip Strength Is an Independent Prognostic Factor for Mortality in Patients with NSCLC Undergoing Radiotherapy (ID 9095)

      09:30 - 09:30  |  Author(s): M.A. Spruit

      • Abstract

      Background:
      Loss of muscle mass and function is common in patients with non-small cell lung cancer. Handgrip strength is a simple screening measure of general limb muscle function which is clearly associated with mortality in the general population and in some chronic disease populations. It is largely unclear to what extent handgrip strength provides prognostic information in patients with non-small cell lung cancer.

      Method:
      Handgrip strength was bilaterally assessed with a Jamar handheld dynamometer before initiation of radiotherapy. Normative values for handgrip strength have been proposed based on centile scores in over 224,000 healthy adults, adjusted for age, sex, height and measurement side. Patients were defined as weak if handgrip strength at one side (left or right) was below the tenth centile of the general population. Cox proportional hazard models were used to assess the relationship between handgrip weakness and mortality. Follow-up time was calculated from the day of assessment. Results are reported unadjusted and adjusted for disease stage (I to IV), World Health Organization Performance Score (WHO PS), gender and age.

      Result:
      We included 1497 patients for analysis (age 68±10; 63% male; stage I:17%; II:9%; III:60%; IV:14%). During follow-up 1109 patients (74%) deceased (time to death 18 ±17 months); mean follow-up in survivors was 46±25 months. Baseline weakness was present in 29% of patients. Unadjusted analysis shows an association between handgrip weakness and mortality (HR 1.64 (1.45-1.86; p<0.001; see figure 1). After covariate adjustment, handgrip weakness remained significantly related to mortality (HR 1.46 (1.27-1.68; p<0.001). Figure 1. Figure 1



      Conclusion:
      Our findings suggest that handgrip strength provides prognostic information in addition to well-established prognostic markers including disease stage, functional performance score and age in NSCLC patients who undergo radiotherapy. The detection of handgrip weakness is easy and quick and therefore might have a role in routine pre-treatment screening in this patient group.