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晚期肝细胞癌患者体成分的影响:SORAMIC 试验的亚分析。

Impact of body composition in advanced hepatocellular carcinoma: A subanalysis of the SORAMIC trial.

机构信息

University Clinic for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.

Department of Radiology, University Hospital, LMU Munich, Munich, Germany.

出版信息

Hepatol Commun. 2023 May 23;7(6). doi: 10.1097/HC9.0000000000000165. eCollection 2023 Jun 1.

Abstract

BACKGROUND

Body composition parameters have been reported to be prognostic factors in patients with oncologic diseases. However, the available data on patients with HCC are conflicting. The aim of this study was to assess the impact of body composition on survival in patients with HCC treated with sorafenib or selective internal radioembolization (SIRT) and sorafenib.

METHODS

This is an exploratory subanalysis of the prospective, randomized controlled SORAMIC trial. Within the palliative arm of the study, patients were selected if a baseline abdominal CT was available. A broad set of skeletal muscle and adipose tissue parameters were measured at the L3 level. Low skeletal muscle mass (LSMM) and density parameters were defined using published cutoffs. The parameters were correlated with overall survival.

RESULTS

Of 424 patients in the palliative study arm, 369 patients were included in the analysis. There were 192 patients in the combined sorafenib/SIRT and 177 patients in the sorafenib group. Median overall survival was 9.9 months for the entire cohort and 10.8 and 9.2 months for the SIRT/sorafenib and sorafenib groups, respectively. There was no relevant association of either body composition parameter with overall survival in either the overall cohort or in the SIRT/sorafenib or sorafenib subgroups.

CONCLUSIONS

This subanalysis of the prospective SORAMIC trial does not suggest a relevant influence of body composition parameters of survival in patients with advanced HCC. Body composition parameters therefore do not serve in patient allocation in this palliative treatment cohort.

摘要

背景

身体成分参数已被报道为肿瘤疾病患者的预后因素。然而,关于 HCC 患者的可用数据存在矛盾。本研究的目的是评估身体成分对接受索拉非尼或选择性内部放射栓塞(SIRT)联合索拉非尼治疗的 HCC 患者生存的影响。

方法

这是前瞻性、随机对照 SORAMIC 试验的探索性亚分析。在研究的姑息治疗臂中,如果有基线腹部 CT 可用,则选择患者。在 L3 水平测量了广泛的骨骼肌和脂肪组织参数。使用已发表的截止值定义低骨骼肌质量(LSMM)和密度参数。参数与总生存期相关。

结果

在姑息治疗研究臂的 424 名患者中,有 369 名患者纳入分析。联合索拉非尼/SIRT 组有 192 例患者,索拉非尼组有 177 例患者。整个队列的中位总生存期为 9.9 个月,SIRT/sorafenib 和 sorafenib 组分别为 10.8 和 9.2 个月。在整个队列或 SIRT/sorafenib 或 sorafenib 亚组中,均未发现任何身体成分参数与总生存期有相关关联。

结论

本前瞻性 SORAMIC 试验的亚分析表明,晚期 HCC 患者的身体成分参数对生存没有明显影响。因此,身体成分参数在该姑息治疗队列的患者分配中没有作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3e2/10208699/e3734eeac5cc/hc9-7-e0165-g001.jpg

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