Imai Kenji, Takai Koji, Unome Shinji, Miwa Takao, Hanai Tatsunori, Suetsugu Atsushi, Shimizu Masahito
Department of Gastroenterology/Internal Medicine, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
Cancers (Basel). 2023 Aug 23;15(17):4223. doi: 10.3390/cancers15174223.
This study aimed to assess the effects of lenvatinib (LEN) or sorafenib (SOR) treatment for hepatocellular carcinoma (HCC) on body composition and changes in body composition on survival. This study enrolled 77 HCC patients. Skeletal muscle index (SMI), subcutaneous and visceral adipose tissue indices (SATI and VATI), AFP, PIVKA-II, and ALBI scores were analyzed at the time of LEN/SOR introduction, three months after the introduction, at treatment discontinuation, and the last observational time. The differences between chronological changes in these values were analyzed using a paired -test. The Cox proportional hazards model was used to analyze prognostic factors using time-varying covariates. The chronological changes in each factor were 45.5-43.6-40.6-39.8 (cm/m) for SMI, 41.7-41.6-36.3-33.7 (cm/m) for SATI, 41.9-41.1-37.1-34.8 (cm/m) for VATI, 2.379-26.42-33.61-36.32 (×10 ng/mL) for AFP, 9.404-13.39-61.34-25.70 (×10 mAU/mL) for PIVKA-II, and -2.56--2.38--1.99--1.90 for the ALBI score. The presence of pre-treatment ( = 0.042), AFP ( = 0.002), PIVKA-II ( < 0.001), ALBI score ( < 0.001), and SMI ( = 0.001) were independent prognostic factors. Skeletal muscle mass decreases significantly during LEN/SOR treatment and is an independent prognostic factor for HCC.
本研究旨在评估乐伐替尼（LEN）或索拉非尼（SOR）治疗肝细胞癌（HCC）对身体成分的影响以及身体成分变化对生存的影响。本研究纳入了77例HCC患者。在开始使用LEN/SOR时、开始使用三个月后、治疗中断时以及最后观察时间，分析骨骼肌指数（SMI）、皮下和内脏脂肪组织指数（SATI和VATI）、甲胎蛋白（AFP）、异常凝血酶原（PIVKA-II）和白蛋白-胆红素（ALBI）评分。使用配对t检验分析这些值随时间变化的差异。使用Cox比例风险模型，通过时变协变量分析预后因素。各因素随时间的变化情况为：SMI为45.5 - 43.6 - 40.6 - 39.8（cm/m），SATI为41.7 - 41.6 - 36.3 - 33.7（cm/m），VATI为41.9 - 41.1 - 37.1 - 34.8（cm/m），AFP为2.379 - 26.42 - 33.61 - 36.32（×10 ng/mL），PIVKA-II为9.404 - 13.39 - 61.34 - 25.70（×10 mAU/mL），ALBI评分为-2.56 - -2.38 - -1.99 - -1.90。治疗前情况（P = 0.042）、AFP（P = 0.002）、PIVKA-II（P < 0.001）、ALBI评分（P < 0.001）和SMI（P = 0.001）是独立的预后因素。在LEN/SOR治疗期间骨骼肌质量显著下降，并且是HCC的一个独立预后因素。
