TY - JOUR
T1 - Handgrip weakness, low fat-free mass, and overall survival in non-small cell lung cancer treated with curative-intent radiotherapy
AU - Burtin, Chris
AU - Bezuidenhout, Jacques
AU - Sanders, Karin J. C.
AU - Dingemans, Anne-Marie C.
AU - Schols, Annemie M. W. J.
AU - Peeters, Stephanie T. H.
AU - Spruit, Martijn A.
AU - De Ruysscher, Dirk K. M.
N1 - Funding Information:
This work was supported by Limburg Kankerfonds and a MUMC2020 grant from Maastricht University Medical Centre. The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing in the . Journal of Cachexia, Sarcopenia and Muscle
Funding Information:
This work was supported by Limburg Kankerfonds and a MUMC2020 grant from Maastricht University Medical Centre. The authors of this manuscript certify that they comply with the ethical guidelines for authorship and publishing in the Journal of Cachexia, Sarcopenia and Muscle.
Publisher Copyright:
© 2020 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of Society on Sarcopenia, Cachexia and Wasting Disorders
PY - 2020/4
Y1 - 2020/4
N2 - Background Assessment of handgrip strength and fat-free mass provides quick and objective information on muscle performance and mass that might complement subjective World Health Organization Performance Status (WHO PS). We investigated to what extent the presence of pre-treatment handgrip weakness and low fat-free mass index (FFMI) provides additional prognostic information on top of well-established prognostic factors (including WHO PS) in non-small cell lung cancer (NSCLC) patients selected for curative-intent (chemo)radiation.Methods Prospectively, patients with early and locally advanced NSCLC (stages I-III) treated with (chemo)radiation were enrolled. Handgrip weakness and low FFMI, derived from bioelectrical impedance analysis, were defined using normative values and were correlated with overall survival (OS).Results We included 936 patients (age 68 +/- 10 years; 64% male; 19% stage I, 9% stage II, and 72% stage III disease; 26% handgrip weakness; 27% low FFMI). In patients with good performance status (WHO PS 0 or 1), handgrip weakness and low FFMI were significant prognostic factors for OS, after adjustment for age, gender, disease stage, and co-morbidities. The combined presence of handgrip weakness and low FFMI was a strong prognostic factor for OS when compared with patients with normal handgrip strength and FFMI (hazard ratio: 1.79, 95% confidence interval: 1.34-2.40, P <0.0001). In patients with impaired performance status (WHO PS >= 2, 19% of sample), handgrip weakness and low FFMI were not related to OS.Conclusions In early and locally advanced NSCLC patients treated with curative-intent (chemo)radiation who have good WHO PS, patients with combined handgrip weakness and low FFMI have the worst prognosis.
AB - Background Assessment of handgrip strength and fat-free mass provides quick and objective information on muscle performance and mass that might complement subjective World Health Organization Performance Status (WHO PS). We investigated to what extent the presence of pre-treatment handgrip weakness and low fat-free mass index (FFMI) provides additional prognostic information on top of well-established prognostic factors (including WHO PS) in non-small cell lung cancer (NSCLC) patients selected for curative-intent (chemo)radiation.Methods Prospectively, patients with early and locally advanced NSCLC (stages I-III) treated with (chemo)radiation were enrolled. Handgrip weakness and low FFMI, derived from bioelectrical impedance analysis, were defined using normative values and were correlated with overall survival (OS).Results We included 936 patients (age 68 +/- 10 years; 64% male; 19% stage I, 9% stage II, and 72% stage III disease; 26% handgrip weakness; 27% low FFMI). In patients with good performance status (WHO PS 0 or 1), handgrip weakness and low FFMI were significant prognostic factors for OS, after adjustment for age, gender, disease stage, and co-morbidities. The combined presence of handgrip weakness and low FFMI was a strong prognostic factor for OS when compared with patients with normal handgrip strength and FFMI (hazard ratio: 1.79, 95% confidence interval: 1.34-2.40, P <0.0001). In patients with impaired performance status (WHO PS >= 2, 19% of sample), handgrip weakness and low FFMI were not related to OS.Conclusions In early and locally advanced NSCLC patients treated with curative-intent (chemo)radiation who have good WHO PS, patients with combined handgrip weakness and low FFMI have the worst prognosis.
KW - Non-small cell lung cancer
KW - Handgrip strength
KW - Fat-free mass
KW - Muscle
KW - Prognosis
KW - X-RAY ABSORPTIOMETRY
KW - BODY-COMPOSITION
KW - PHYSICAL FUNCTION
KW - PROGNOSTIC-FACTOR
KW - SARCOPENIA
KW - STRENGTH
KW - RELIABILITY
KW - CACHEXIA
U2 - 10.1002/jcsm.12526
DO - 10.1002/jcsm.12526
M3 - Article
C2 - 32045108
SN - 2190-5991
VL - 11
SP - 424
EP - 431
JO - Journal of cachexia, sarcopenia and muscle
JF - Journal of cachexia, sarcopenia and muscle
IS - 2
ER -