{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:22:20Z","timestamp":1792221740585,"version":"4.4.0"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T00:00:00Z","timestamp":1686787200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hand grip strength (HGS) is a widely used functional test for the assessment of strength and functional status in patients with cancer, in particular with cancer cachexia. The aim was to prospectively evaluate the prognostic value of HGS in patients with mostly advanced cancer with and without cachexia and to establish reference values for a European\u2010based population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this prospective study, 333 patients with cancer (85% stage III\/IV) and 65 healthy controls of similar age and sex were enrolled. None of the study participants had significant cardiovascular disease or active infection at baseline. Repetitive HGS assessment was performed using a hand dynamometer to measure the maximal HGS (kilograms). Presence of cancer cachexia was defined when patients had \u22655% weight loss within 6\u00a0months or when body mass index was &lt;20.0\u00a0kg\/m<jats:sup>2<\/jats:sup> with \u22652% weight loss (Fearon's criteria). Cox proportional hazard analyses were performed to assess the relationship of maximal HGS to all\u2010cause mortality and to determine cut\u2010offs for HGS with the best predictive power. We also assessed associations with additional relevant clinical and functional outcome measures at baseline, including anthropometric measures, physical function (Karnofsky Performance Status and Eastern Cooperative of Oncology Group), physical activity (4\u2010m gait speed test and 6\u2010min walk test), patient\u2010reported outcomes (EQ\u20105D\u20105L and Visual Analogue Scale appetite\/pain) and nutrition status (Mini Nutritional Assessment).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean age was 60\u00a0\u00b1\u00a014\u00a0years; 163 (51%) were female, and 148 (44%) had cachexia at baseline. Patients with cancer showed 18% lower HGS than healthy controls (31.2\u00a0\u00b1\u00a011.9 vs. 37.9\u00a0\u00b1\u00a011.6\u00a0kg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Patients with cancer cachexia had 16% lower HGS than those without cachexia (28.3\u00a0\u00b1\u00a010.1 vs. 33.6\u00a0\u00b1\u00a012.3\u00a0kg, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Patients with cancer were followed for a mean of 17\u00a0months (range 6\u201350), and 182 (55%) patients died during follow\u2010up (2\u2010year mortality rate 53%) (95% confidence interval 48\u201359%). Reduced maximal HGS was associated with increased mortality (per \u22125\u00a0kg; hazard ratio [HR] 1.19; 1.10\u20131.28; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001; independently of age, sex, cancer stage, cancer entity and presence of cachexia). HGS was also a predictor of mortality in patients with cachexia (per \u22125\u00a0kg; HR 1.20; 1.08\u20131.33; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) and without cachexia (per \u22125\u00a0kg; HR 1.18; 1.04\u20131.34; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.010). The cut\u2010off for maximal HGS with the best predictive power for poor survival was &lt;25.1\u00a0kg for females (sensitivity 54%, specificity 63%) and &lt;40.2\u00a0kg for males (sensitivity 69%, specificity 68%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Reduced maximal HGS was associated with higher all\u2010cause mortality, reduced overall functional status and decreased physical performance in patients with mostly advanced cancer. Similar results were found for patients with and without cancer cachexia.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13248","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T11:29:32Z","timestamp":1686828572000},"page":"1682-1694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["Hand grip strength in patients with advanced cancer: A prospective study"],"prefix":"10.1002","volume":"14","author":[{"given":"Sara","family":"Hadzibegovic","sequence":"first","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care CBF Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Porthun","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine CVK Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"},{"name":"Norwegian University of Science and Technology, Campus Gj\u00f8vik  Gj\u00f8vik Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Lena","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Angiology and Intensive Care CBF Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"},{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Weinl\u00e4nder","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine CVK Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"L\u00fcck","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Berlin  Berlin Germany"},{"name":"Berlin Institute of Health Center for Regenerative Therapies (BCRT)  Berlin Germany"},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine CVK Deutsches Herzzentrum der Charit\u00e9  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia K.","family":"Potthoff","sequence":"additional","affiliation":[{"name":"Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t Berlin and Humboldt\u2010Universit\u00e4t zu Berlin  Berlin Germany"},{"name":"German Centre for Cardiovascular Research (DZHK), partner site Berlin  Berlin Germany"},{"name":"Berlin Institute of 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