O012 - HANDGRIP STRENGTH AND ALBUMIN-GLOBULIN RATIO PREDICT SURVIVAL IN ESOPHAGEAL CANCER: A MULTICENTER COHORT STUDY

O012

HANDGRIP STRENGTH AND ALBUMIN-GLOBULIN RATIO PREDICT SURVIVAL IN ESOPHAGEAL CANCER: A MULTICENTER COHORT STUDY

X. Dai^1,*, X. Zhang¹, M. Cong¹

¹Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

Rationale: Esophageal cancer (EC) is one of the most lethal malignancies worldwide. This poor prognosis is partly attributed to malnutrition resulting from dysphagia and systemic metabolic alterations. Handgrip strength (HGS) and albumin-to-globulin ratio (AGR), are emerging prognostic tools in cancer care. However, their utility in predicting survival in EC remains unclear. This study aims to evaluate the independent and joint prognostic value of HGS and AGR in EC.

Methods: This multicenter cohort study enrolled 1,621 patients for analysis. Model construction and cross-validation of random forest were used to identify variables associated with mortality. Patients were stratified into high/low HGS and AGR groups using predefined thresholds. The Kaplan-Meier method was used to create survival curves. Multivariable Cox regression models were employed to assess associations with overall survival (OS). The predictive performance of HGS, AGR, and their combination was compared using concordance index (C-index) and receiver operating characteristic (ROC) curves.

Results: HGS and AGR were important variables identified. In multivariable analyses, both low HGS (HR=1.413, 95% CI: 1.159–1.723, P<0.001) and low AGR (HR=1.509, 95% CI: 1.185–1.923, P<0.001) independently predicted poorer OS. Patients with combined low HGS and low AGR exhibited the highest mortality risk (HR=2.208, 95% CI: 1.598–3.051, P<0.001). The HGS-AGR model demonstrated superior prognostic accuracy compared to individual parameters. Stratified analyses revealed similar predictive efficacy. Additionally, low HGS and low AGR were significantly associated with high risk of malnutrition or poor QoL.

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Conclusion: HGS and AGR independently hold significant prognostic value in EC patients. Their combined use facilitates precise survival risk stratification and the identification of high-risk patients for malnutrition and adverse clinical outcomes.

Disclosure of Interest: None declared