Low handgrip strength as a marker of severity in the diagnostic criteria for cancer cachexia

Abstract

Background & aims: The diagnostic criteria for cachexia, as proposed by the Asian Working Group for Cachexia (AWGC), include weight loss, a low body mass index, and additional factors such as a low handgrip strength (HGS), anorexia, or elevated CRP levels. This study aimed to evaluate the significance of low HGS as a diagnostic criterion in patients with advanced cancer.

Methods: This single-centre, retrospective cohort study was conducted between April 2019 and March 2023. Patients aged ≥18 years with malignant diseases were included. Patients without records on HGS were excluded. Low HGS was defined as a HGS <28 kg for men and <18 kg for women. The overall median survival time (MST) was analysed by univariate and multivariate analyses.

Results: A total of 894 patients were analysed. Cachexia was prevalent in 74 %, though only 3.4 % were diagnosed based solely on low HGS. The MST in patients with cachexia was 122 days, and in those with low HGS was 73 days. The associations between low HGS and high mortality remained significant after adjusting for AWGC criteria, modified weight loss grading system, age, gender, performance status, calf circumferenceand fluid retention. The MST varied with the number of additional factors being met: 422 days for one criterion, 92 days for two, and 55 days for all three (p < 0.0001).

Conclusion: This study supports that HGS serve as important prognostic tool in patients with various cancers.

Keywords: Cancer cachexia; Diagnostic criteria; Hand grip strength; The Asian working group for cachexia.