Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinoma

Helena Orell; Anne Pohju; Paula Ravasco; Ursula Schwab; Pia Osterlund; Antti A. Mäkitie

doi:10.1016/j.clnesp.2026.103312

Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinoma

Helena Orell
, Anne Pohju
, Paula Ravasco
, Ursula Schwab
, Pia Osterlund
, Antti A. Mäkitie

Dentistry

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND: Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival.

METHODS: This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m 2). Chi-square, Kaplan-Meier, and Cox analyses were used.

RESULTS: Low HGS was observed in 16%, low FFMI in 46%, and sarcopenia in 12%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95% CI 1.5-9.1] and 5.5, [2.2-14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size.

CONCLUSION: In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival.

CLINICAL TRIAL REGISTRATION: www.

CLINICALTRIALS: gov, identifier NCT02159508.

Original language	English
Article number	103312
Journal	Clinical Nutrition ESPEN
Volume	73
DOIs	https://doi.org/10.1016/j.clnesp.2026.103312
Publication status	Published - Jun 2026

Keywords

EWGSOP
GLIM
Handgrip strength
Head and neck cancer
Malnutrition
Nutritional status
Oncology
PG-SGA
Sarcopenia
Body Mass Index
Prospective Studies
Humans
Middle Aged
Squamous Cell Carcinoma of Head and Neck/mortality
Kaplan-Meier Estimate
Proportional Hazards Models
Male
Sarcopenia/physiopathology
Aged
Nutritional Status
Head and Neck Neoplasms/complications
Hand Strength

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10.1016/j.clnesp.2026.103312

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@article{b49942003be74c0eab6f646eec7b32d8,

title = "Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinoma",

abstract = "BACKGROUND: Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival.METHODS: This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m 2). Chi-square, Kaplan-Meier, and Cox analyses were used. RESULTS: Low HGS was observed in 16\%, low FFMI in 46\%, and sarcopenia in 12\%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95\% CI 1.5-9.1] and 5.5, [2.2-14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size.CONCLUSION: In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival.CLINICAL TRIAL REGISTRATION: www.CLINICALTRIALS: gov, identifier NCT02159508.",

keywords = "EWGSOP, GLIM, Handgrip strength, Head and neck cancer, Malnutrition, Nutritional status, Oncology, PG-SGA, Sarcopenia, Body Mass Index, Prospective Studies, Humans, Middle Aged, Squamous Cell Carcinoma of Head and Neck/mortality, Kaplan-Meier Estimate, Proportional Hazards Models, Male, Sarcopenia/physiopathology, Aged, Nutritional Status, Head and Neck Neoplasms/complications, Hand Strength",

author = "Helena Orell and Anne Pohju and Paula Ravasco and Ursula Schwab and Pia Osterlund and M{\"a}kitie, \{Antti A.\}",

year = "2026",

month = jun,

doi = "10.1016/j.clnesp.2026.103312",

language = "English",

volume = "73",

journal = "Clinical Nutrition ESPEN",

issn = "2405-4577",

publisher = "Elsevier Ltd.",

}

TY - JOUR

T1 - Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinoma

AU - Orell, Helena

AU - Pohju, Anne

AU - Ravasco, Paula

AU - Schwab, Ursula

AU - Osterlund, Pia

AU - Mäkitie, Antti A.

PY - 2026/6

Y1 - 2026/6

N2 - BACKGROUND: Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival.METHODS: This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m 2). Chi-square, Kaplan-Meier, and Cox analyses were used. RESULTS: Low HGS was observed in 16%, low FFMI in 46%, and sarcopenia in 12%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95% CI 1.5-9.1] and 5.5, [2.2-14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size.CONCLUSION: In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival.CLINICAL TRIAL REGISTRATION: www.CLINICALTRIALS: gov, identifier NCT02159508.

AB - BACKGROUND: Low handgrip strength (HGS) and sarcopenia are common in patients with head and neck squamous cell carcinoma (HNSCC). This study aimed to explore associations between baseline HGS, fat-free mass index (FFMI), nutritional indices, and survival.METHODS: This was a prospective observational sub-study of a randomized nutritional intervention trial, including 50 male patients with HNSCC undergoing curative-intent treatment (surgery and/or (chemo)radiotherapy). Sarcopenia was defined as low HGS (<27 kg) and FFMI (<17 kg/m 2). Chi-square, Kaplan-Meier, and Cox analyses were used. RESULTS: Low HGS was observed in 16%, low FFMI in 46%, and sarcopenia in 12%. Patients with low HGS had lower body weight, BMI, and FFMI, alongside more malnutrition, elevated CRP, and heavy smoking. Low HGS and sarcopenia were associated with shorter overall survival (HR 3.7, [95% CI 1.5-9.1] and 5.5, [2.2-14.5], respectively); FFMI was not. Adjustment removed significance. Findings should be interpreted cautiously due to the small, all-male cohort size.CONCLUSION: In this small exploratory cohort HGS may serve as a simple screening surrogate for sarcopenia and survival.CLINICAL TRIAL REGISTRATION: www.CLINICALTRIALS: gov, identifier NCT02159508.

KW - EWGSOP

KW - GLIM

KW - Handgrip strength

KW - Head and neck cancer

KW - Malnutrition

KW - Nutritional status

KW - Oncology

KW - PG-SGA

KW - Sarcopenia

KW - Body Mass Index

KW - Prospective Studies

KW - Humans

KW - Middle Aged

KW - Squamous Cell Carcinoma of Head and Neck/mortality

KW - Kaplan-Meier Estimate

KW - Proportional Hazards Models

KW - Male

KW - Sarcopenia/physiopathology

KW - Aged

KW - Nutritional Status

KW - Head and Neck Neoplasms/complications

KW - Hand Strength

UR - https://www.scopus.com/pages/publications/105038177685

U2 - 10.1016/j.clnesp.2026.103312

DO - 10.1016/j.clnesp.2026.103312

M3 - Article

C2 - 42069057

AN - SCOPUS:105038177685

SN - 2405-4577

VL - 73

JO - Clinical Nutrition ESPEN

JF - Clinical Nutrition ESPEN

M1 - 103312

ER -

Get a grip! – Baseline handgrip strength and sarcopenia as predictors of survival in patients with head and neck squamous cell carcinoma

Abstract

Keywords

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