Labenz Christian, Prenosil Vera, Koch Sandra, Huber Yvonne, Marquardt Jens U, Schattenberg Jörn M, Galle Peter R, Weinmann Arndt, Wörns Marcus-Alexander
Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
Dig Dis. 2018;36(1):78-88. doi: 10.1159/000477578. Epub 2017 Jul 4.
BACKGROUND/AIM: Individual components of the metabolic syndrome (MS) such as obesity or diabetes mellitus impair the prognosis of patients with hepatocellular carcinoma (HCC) following curative treatment approaches or transarterial therapies. The aim of this retrospective study was to assess the impact of these factors on the overall survival (OS) of patients with advanced HCC treated with sorafenib.
Univariate and multivariate analyses were performed to assess the impact of individual components of the MS on the OS of 152 consecutive patients with advanced HCC treated with sorafenib.
The presence of overweight/obesity, type 2 diabetes mellitus, hypertension, dyslipidemia, and of the MS itself did not impair the median OS. Multivariate analysis showed that Eastern Cooperative Oncology Group Performance Status ≥1 (hazards ratio [HR] 2.03), presence of macrovascular invasion (HR 1.71), Child-Pugh score B/C (HR 2.19), tumor grading G3 (HR 2.17), no prior HCC treatment (HR 2.34), and the presence of 2 or more out of 5 individual components of the MS (HR 0.65) were independent prognostic factors regarding the median OS.
Our investigations do not confirm a negative prognostic role of individual components of the MS or the MS itself for patients with advanced HCC treated with sorafenib.
背景/目的：代谢综合征（MS）的各个组成部分，如肥胖或糖尿病，会损害肝细胞癌（HCC）患者在接受根治性治疗或经动脉治疗后的预后。这项回顾性研究的目的是评估这些因素对接受索拉非尼治疗的晚期HCC患者总生存期（OS）的影响。
对152例连续接受索拉非尼治疗的晚期HCC患者进行单因素和多因素分析，以评估MS各组成部分对OS的影响。
超重/肥胖、2型糖尿病、高血压、血脂异常以及MS本身的存在并未影响中位总生存期。多因素分析显示，东部肿瘤协作组体能状态≥1（风险比[HR]2.03）、存在大血管侵犯（HR 1.71）、Child-Pugh评分B/C（HR 2.19）、肿瘤分级G3（HR 2.17）、既往未接受过HCC治疗（HR 2.34）以及MS的5个个体组成部分中存在2个或更多（HR 0.65）是关于中位总生存期的独立预后因素。
我们的研究未证实MS的各个组成部分或MS本身对接受索拉非尼治疗的晚期HCC患者具有负面预后作用。
