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仑伐替尼治疗肝细胞癌患者肌少症的预后意义:一项回顾性分析。

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma treated with lenvatinib: A retrospective analysis.

机构信息

Department of Radiology, First Hospital of Jilin University, Changchun, China.

Cancer Center, First Hospital of Jilin University, Changchun, China.

出版信息

Medicine (Baltimore). 2022 Feb 4;101(5):e28680. doi: 10.1097/MD.0000000000028680.

Abstract

Our study investigated the correlation between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma (HCC) treated with lenvatinib. We retrospectively evaluated 40 consecutive patients with unresectable HCC receiving lenvatinib between November 2018 and May 2020 at the First Hospital of Jilin University. Skeletal muscle mass was measured before treatment initiation. Prognostic significance was assessed with univariate and multivariate Cox proportional hazards models. Overall survival (OS) and progression-free survival (PFS) were evaluated for patients with and without sarcopenia. Sarcopenia was present in 23/40 patients (57.5%). After a median follow-up of 9.2 months, patients with sarcopenia had significantly worse OS and PFS compared with those without sarcopenia (OS: 8.4 months [m] vs 14.7 m, P = .02; PFS: 4.2 m vs 9.0 m, P = .04). Multivariate Cox proportional hazards models identified presence of sarcopenia as an independent risk factor for shorter OS (hazard ratio [HR], 0.257; 95% confidence interval [CI], 0.083-0.794; P = .02). In subgroup analysis, sarcopenia was associated with worse survival than non-sarcopenic patients, irrespective of age, Barcelona clinic liver cancer stage, or albumin-bilirubin grade. Our results show sarcopenia may be a predictor of poor prognosis in patients with HCC receiving lenvatinib. Management of sarcopenia is a vital factor for improving survival outcomes in patients with HCC.

摘要

我们的研究调查了接受仑伐替尼治疗的肝细胞癌(HCC)患者中肌肉减少症与临床结局的相关性。我们回顾性评估了 2018 年 11 月至 2020 年 5 月在吉林大学第一医院接受仑伐替尼治疗的 40 例不可切除 HCC 连续患者。在治疗开始前测量骨骼肌质量。使用单因素和多因素 Cox 比例风险模型评估预后意义。评估有无肌肉减少症的患者的总生存期(OS)和无进展生存期(PFS)。40 例患者中有 23 例(57.5%)存在肌肉减少症。中位随访 9.2 个月后,有肌肉减少症的患者 OS 和 PFS 明显差于无肌肉减少症的患者(OS:8.4 个月[m] vs 14.7 m,P=0.02;PFS:4.2 个月 vs 9.0 m,P=0.04)。多因素 Cox 比例风险模型确定存在肌肉减少症是 OS 较短的独立危险因素(风险比 [HR],0.257;95%置信区间 [CI],0.083-0.794;P=0.02)。亚组分析显示,无论年龄、巴塞罗那临床肝癌分期或白蛋白-胆红素分级如何,肌肉减少症与非肌肉减少症患者的生存较差相关。我们的研究结果表明,肌肉减少症可能是接受仑伐替尼治疗的 HCC 患者预后不良的预测因素。肌肉减少症的管理是改善 HCC 患者生存结局的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/221f/8812594/50f99ae08b68/medi-101-e28680-g001.jpg

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