Effect of low skeletal muscle mass combined with low muscle strength to predict survival in patients with incurable cancer

Background & aims: The study aimed to evaluate the effect of muscle mass, alone and combined with muscle strength, in predicting survival in patients with incurable cancer. Muscle mass was assessed by computed tomography (CT). Method: Low muscle mass and low muscle strength was defined, respectively, by skeletal muscle index (SMI) assessed by CT and handgrip strength (HGS) below the first tertile of the studied sample, as follow: SMI < 41.3 or < 34.9 cm2/m2 (male/female) and HGS < 20 or < 13 kg (male/female). Kaplan Meier curves, and Cox-regression models were applied to analyze overall survival (OS) outcomes. Results: A total of 386 patients were included, and the median OS was 43 [interquartile range (IQR): 15 -96] days. Considering the appropriate SMI and HGS as the reference group, a significantly lower OS was observed in the group with low SMI + low HGS [54 (IQR: 38-69) versus 22 (IQR: 10-33) days; p < 0.001]. Patients with low HGS alone presented lower OS than those of the appropriate group [52 (IQR: 42-61) versus 24 (IQR: 17-30) days; p < 0.001], but no differences were observed in the groups with low SMI alone versus appropriate [46 (IQR: 35-56) versus 40 (IQR: 30-49) days; p 1/4 0.365]. The adjusted Cox regression demonstrated that low HGS alone [hazard ratio (HR): 1.51; 95% confidence interval (CI): 1.20 -1.91] and low SMI + low HGS group (HR: 1.77; 95% IC: 1.28-2.4 4) had higher risk of 180-day mortality. Muscle mass combined with muscle strength improved OS prediction compared to these measurements alone in patients with incurable cancer. (c) 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.