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Title: | Handgrip weakness, low fat-free mass, and overall survival in non-small cell lung cancer treated with curative-intent radiotherapy | Authors: | BURTIN, Chris Bezuidenhout, Jacques Sanders, Karin J. C. Dingemans, Anne-Marie C. Schols, Annemie M. W. J. Peeters, Stephanie T. H. De Ruysscher, Dirk K. M. SPRUIT, Martijn A. |
Issue Date: | 2020 | Publisher: | WILEY | Source: | JOURNAL OF CACHEXIA SARCOPENIA AND MUSCLE, 11 (2) , p. 424 -431 | Status: | Early view | Abstract: | 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. | Notes: | De Ruysscher, DKM (reprint author), Maastricht Univ, GROW Sch Oncol & Dev Biol, Med Ctr, Dept Radiat Oncol,MAASTRO Clin, Dr Tanslaan 12, NL-6229 ET Maastricht, Netherlands. dirk.deruysscher@maastro.nl |
Other: | De Ruysscher, DKM (reprint author), Maastricht Univ, GROW Sch Oncol & Dev Biol, Med Ctr, Dept Radiat Oncol,MAASTRO Clin, Dr Tanslaan 12, NL-6229 ET Maastricht, Netherlands. dirk.deruysscher@maastro.nl | Keywords: | Non-small cell lung cancer;Handgrip strength;Fat-free mass;Muscle;Prognosis | Document URI: | http://hdl.handle.net/1942/30713 | ISSN: | 2190-5991 | e-ISSN: | 2190-6009 | DOI: | 10.1002/jcsm.12526 | ISI #: | WOS:000512483900001 | Rights: | 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 Journal of Cachexia, Sarcopenia and Muscle (2020) Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/jcsm.12526 This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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