Brazilian Journal of Oncology · Jun 26, 2026
Association of Handgrip Strength, Adductor Pollicis Muscle Thickness and SARC-F Questionnaire with Short- and Long-Term Survival in Patients with Advanced Cancer
By Machado AM, Menezes TM, Raupp JL et al.
All articles of this category (opens in new window) Address for correspondence Yara Cristina de Paiva Maia (yara.maia@ufu.br) Survival prediction is critical to guide clinical decisions, treatment planning, and to support patients and families. Although several prognostic tools exist, many are subjective, and there is a need for accessible, objective methods in routine care. This study aimed to evaluate the association of handgrip strength (HGS), adductor pollicis muscle thickness (APMT), and the Strength, Assistance with Walking, Rising from a Chair, Climbing Stairs, and Falls questionnaire (SARC-F) with survival in patients with advanced solid tumors. A prospective study was conducted at a public hospital in Uberlândia, Brazil, including 87 participants aged ≥18 years, with advanced solid tumors and under palliative care. Adductor Pollicis Muscle Thickness were assessed using an skinfold caliper and malnutrition cutoff point was defined as <13,1mm. Handgrip strength was assessed with a dynamometer and categorized as: for women, ≥20 kg (normal strength), 16–19.99 kg (intermediate strength), ≤16 kg (low strength); for men, ≥32 kg (normal strength), 26–31.99 kg (intermediate strength), ≤26 kg (low strength). SARC-F was administered during clinical visits; scores ≥4 indicated the risk of sarcopenia. Survival was analyzed from the time of inclusion in the study until the deadline defined as December 2024. Survival was divided into three cutoff points: 180, 365 and 730 days. Cox regression analysis was performed. Gender and age were adjusted in the model. HGS, SARC-F scores, intermediate strength, and low strength were significantly associated with 180-day survival (p=0.05, χ²=50.16; p=0.01, χ²=47.06; p=0.02, β=2.14; p=0.02, β=2.00, respectively) and 365-day survival (p=0.01, χ²=57.30; p=0.03, χ²=51.27; p=0.04, β=1.71; p=0.00, β=2.63, respectively). HGS, SARC-F scores and low strength were significantly associated with 730-day survival (p=0.008, χ²=59.64; p=0.03, χ²=51.45; p=0.00, β=1.96, respectively). APMT was not significantly associated with survival. In conclusion, handgrip strength and SARC-F are associated with survival in patients with advanced cancer and may serve as practical, low-cost prognostic tools in clinical settings. The lack of association between APMT and survival suggests that early assessment of functional decline and muscle strength may be more informative than muscle mass loss alone. Publication History Article published online: 26 June 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil Bibliographical Record Andressa Miranda Machado, Taysa Machado Menezes, Juliana Liduário Raupp, Pedro Augusto do Amaral, Bruna Maria Malagoli Rocha Santos, Paula Philbert Lajolo Canto, Carlos Eduardo Paiva, Yara Cristina de Paiva Maia. Association of Handgrip Strength, Adductor Pollicis Muscle Thickness and SARC-F Questionnaire with Short- and Long-Term Survival in Patients with Advanced Cancer. Brazilian Journal of Oncology 2026; 22. DOI: 10.1055/s-0046-1825365