Prognostic Value of Handgrip Strength in Lung Cancer: Findings From a Multicenter Prospective Cohort Study

BackgroundHandgrip strength (HGS), a simple and practical indicator of skeletal muscle function, has emerged as a potential prognostic marker, yet its predictive value in lung cancer remains to be fully elucidated. This study aimed to evaluate the prognostic significance of HGS for Overall Survival (OS) in patients with lung cancer, and to develop a prognostic model integrating HGS and hematologic parameters.MethodsThis prospective cohort study was based on the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC). A total of 3604 pathologically confirmed lung cancer patients were included. Demographic, clinical, and nutrition-related data were collected. The association between HGS and OS was assessed using Cox proportional hazards models. A nomogram was developed, and its predictive performance was evaluated using receiver operating characteristic (ROC) curves and the concordance index (C-index).ResultsHGS was significantly associated with OS in patients with lung cancer. Compared with the lowest quartile (Q1), patients in Q2, Q3, and Q4 showed 23.9% (HR = 0.761, 95% CI: 0.666-0.869, P < 0.001), 21.3% (HR = 0.787, 95%CI: 0.684-0.907, P = 0.001), and 41.1% (HR = 0.589, 95% CI: 0.506-0.686, P < 0.001) reductions in mortality risk, respectively. In multivariate analysis, sex, HGS, and hemoglobin were identified as independent protective factors, while elevated serum glucose and platelet count were independent risk factors for poor prognosis. The nomogram model constructed based on these variables yielded area under the curve (AUC) values of 64.2%, 61.3%, and 59.8% for predicting 1-, 2-, and 3-year OS, respectively, with a C-index of 0.607 (95% CI: 0.593-0.621), outperforming HGS alone (C-index = 0.541) or any single hematological parameter.ConclusionsHGS is an independent predictor of survival in lung cancer. Combining HGS with hematologic indicators enhances prognostic accuracy. The developed nomogram may serve as a practical tool for individualized prognostication and nutrition-based interventions.