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

Tatsuma Sakaguchi; Keisuke Maeda; Tomoko Takeuchi; Yuria Ishida; Ryoko Kato; Junko Ueshima; Akio Shimizu; Ayano Nagano; Koki Kawamura; Koji Amano; Naoharu Mori

doi:10.1016/j.clnesp.2024.10.162

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

Clin Nutr ESPEN. 2024 Dec:64:435-440. doi: 10.1016/j.clnesp.2024.10.162. Epub 2024 Nov 1.

Authors

Tatsuma Sakaguchi¹, Keisuke Maeda², Tomoko Takeuchi³, Yuria Ishida⁴, Ryoko Kato⁵, Junko Ueshima⁶, Akio Shimizu⁷, Ayano Nagano⁸, Koki Kawamura⁹, Koji Amano¹⁰, Naoharu Mori¹¹

Affiliations

¹ Palliative Care Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan. Electronic address: [email protected].
² Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology University, 7-430, Morioka, Obu, Aichi 474-8511, Japan.
³ Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
⁴ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutrition, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
⁵ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Pharmacy, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
⁶ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nutritional Service, NTT Medical Center Tokyo, 5-9-22 Higashi-Gotanda, Shinagawa-ku, Tokyo 141-8625, Japan.
⁷ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Health Science, Faculty of Health and Human Development, University of Nagano, 8-49-7 Miwa, Nagano-shi, Nagano 380-8525, Japan.
⁸ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Nursing, Nishinomiya Kyoritsu Neurosurgical Hospital, 11-1 Imazuyamanaka-cho, Nishinomiya 663-8211, Japan.
⁹ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Rehabilitation, Hospital, National Center for Geriatrics and Gerontology, 7-430, Morioka, Obu, Aichi, 474-8511, Japan.
¹⁰ Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Supportive and Palliative Care, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka 541-8567, Japan.
¹¹ Palliative Care Center, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan; Department of Palliative and Supportive Medicine, Graduate School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.

PMID: 39489299
DOI: 10.1016/j.clnesp.2024.10.162

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.

MeSH terms

Adult
Aged
Aged, 80 and over
Body Mass Index
Cachexia* / diagnosis
Cachexia* / physiopathology
Female
Hand Strength*
Humans
Male
Middle Aged
Neoplasms* / complications
Retrospective Studies
Severity of Illness Index
Weight Loss