Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima City, Fukushima, 960-1295, Japan.
Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan.
Sci Rep. 2022 Apr 20;12(1):6479. doi: 10.1038/s41598-022-10514-3.
Sarcopenia is associated with poor prognosis of patients with hepatocellular carcinoma (HCC). We investigated the association of skeletal muscle volume (SMV) and its change in HCC patients taking lenvatinib. In 130 HCC patients, psoas mass index (PMI) was calculated as the left-right sum of the major × minor axis of psoas muscle at the third lumbar vertebra, divided by height squared. Patients were classified into two groups (low and normal PMI) based on indices of < 6.0 cm/m for man and < 3.4 cm/m for women. Change in PMI per month during the lenvatinib administration period (ΔPMI/m) was calculated; and patients were classified into two groups (severe and mild atrophy) based on the ΔPMI/m rate, as ≥ 1% or < 1%, respectively. There was no significant difference in Overall survival (OS) between the low and normal PMI groups at the start of lenvatinib administration. OS was significantly lower in the severe atrophy group than in the mild atrophy group (median; 15.2 vs. 25.6 months, P = 0.005). Multivariate analysis revealed a significant association of severe atrophy with OS (hazard ratio 1.927, P = 0.031). Progressive loss of SMV is a strong predictor of poor prognosis in HCC patients taking lenvatinib.
肌肉减少症与肝细胞癌（HCC）患者的预后不良有关。我们研究了骨骼肌体积（SMV）及其在接受仑伐替尼治疗的 HCC 患者中的变化与 HCC 之间的关系。在 130 例 HCC 患者中，通过计算第三腰椎处左右两侧的竖脊肌的长轴与短轴的乘积，再除以身高的平方，得出腰大肌质量指数（PMI）。根据男性<6.0 cm/m 和女性<3.4 cm/m 的指数，将患者分为低和正常 PMI 两组。计算仑伐替尼治疗期间 PMI 每月的变化（ΔPMI/m）；根据ΔPMI/m 率将患者分为严重和轻度萎缩两组，分别为≥1%或<1%。在开始接受仑伐替尼治疗时，低和正常 PMI 两组之间的总体生存率（OS）没有显著差异。严重萎缩组的 OS 明显低于轻度萎缩组（中位数：15.2 与 25.6 个月，P=0.005）。多因素分析显示，严重萎缩与 OS 显著相关（危险比 1.927，P=0.031）。SMV 进行性丧失是接受仑伐替尼治疗的 HCC 患者预后不良的一个强烈预测因素。
