In several malignancies, the likelihood of death has been predicted using systemic inflammation and hand grip weakening. For a study, researchers sought to assess the relationship between handgrip weakness and the co-occurrence of inflammatory markers and overall survival (OS) in lung cancer (LC) patients with excellent performance status.

Maxstat was used to determine the handgrip strength (HGS) and 4 inflammatory indication cutoff values. The best inflammatory indicator for predicting OS of LC patients was chosen using the time-dependent receiver operating characteristic curve and C-index. The mortality hazard ratio (HR) was calculated using the Cox proportional hazard regression model. Kaplan-Meier curves were created to assess the relationship between markers and the OS of LC patients.

The mean ± standard deviation (SD) age of the 1,951 patients was 60.6±9.9 years, with 1,300 (66.6%) of them being men. In patients with good performance status (PS), handgrip weakness (HR, 1.49; 95% CI, 1.30-1.70, P<0.001) and low advanced lung cancer inflammation index (ALI) (HR, 2.05; 95% CI, 1.79-2.34, P<0.001), high systemic immune-inflammation index (SII) (HR, 1.91; 95% CI, 1.66-2.19, P<0.001), high platelet: lymphocyte ratio (PLR) (HR, 1.60; 95% CI, 1.40–1.82, P<0.001), or high neutrophil: lymphocyte ratio (NLR) (HR, 2.01; 95% CI, 1.76–2.30, P<0.001) were associated with increased mortality risk of LC patients. When predicting OS in LC patients with decent PS, ALI performed better than the other 3 combinations with a C-index of 0.624 and a time-AUC of 0.58. The risk of mortality in LC with excellent PS was more than doubled when handgrip weakness and poor ALI were present (HR, 2.44; 95% CI, 2.06-2.89, P<0.001).

Patients with paired handgrip weakness, and poor ALI had the worst outcome among LC patients with excellent PS.