Bai Yaowei, Liu Jiacheng, Wang Ying, Zhou Binqian, Liu Xiaoming, Dong Xiangjun, Zheng Chuansheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
J Cancer. 2024 Feb 4;15(7):1837-1847. doi: 10.7150/jca.92976. eCollection 2024.
This study aimed to investigate the prognostic effect of sarcopenia on primary hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE). This retrospective study enrolled 265 patients diagnosed with HCC who underwent TACE between April 2014 and February 2021. The patients were divided into two groups: the sarcopenia group (n=133) and the non-sarcopenia group (n=132). The study analyzed the differences in overall survival (OS) and progression-free survival (PFS) using Kaplan-Meier curves. The independent risk factors for OS and PFS were determined using univariate and multivariate Cox regression analysis. Based on these factors, the study constructed a prognostic risk grading system. At 3 and 6 months post-TACE, the prognoses of the sarcopenia group were worse than that of the non-sarcopenia group according to the mRECIST criteria. Kaplan-Meier curves showed that the cumulative OS and PFS rate in the non-sarcopenia group were significantly higher compared to the sarcopenia group (HR=3.319, 95%CI: 2.283-4.824, Log-rank < 0.001; HR=0.631, 95%CI: 0.486-0.820, Log-rank < 0.001). Sarcopenia, maximal tumor diameter, and AFP ≥ 200 ng/mL were independent risk factors for OS and PFS. The prognostic risk grading system based on sarcopenia, AFP ≥ 200 ng/mL, and maximal tumor diameter≥8.9 cm showed significant differences in prognosis between risk groups. Sarcopenia had excellent predictive value for OS and PFS in patients after TACE, and AFP ≥ 200 ng/mL and maximal tumor diameter were also independent risk factors for a poor prognosis. The prognostic risk grading system based on sarcopenia, AFP, and maximal tumor diameter had good guiding value for the prognosis of patients.
本研究旨在探讨肌肉减少症对经动脉化疗栓塞术（TACE）后原发性肝细胞癌（HCC）患者的预后影响。这项回顾性研究纳入了2014年4月至2021年2月期间接受TACE治疗的265例确诊为HCC的患者。患者分为两组：肌肉减少症组（n = 133）和非肌肉减少症组（n = 132）。该研究使用Kaplan-Meier曲线分析总生存期（OS）和无进展生存期（PFS）的差异。使用单因素和多因素Cox回归分析确定OS和PFS的独立危险因素。基于这些因素，该研究构建了一个预后风险分级系统。根据改良RECIST标准，在TACE术后3个月和6个月时，肌肉减少症组的预后比非肌肉减少症组更差。Kaplan-Meier曲线显示，非肌肉减少症组的累积OS和PFS率显著高于肌肉减少症组（HR = 3.319，95%CI：2.283 - 4.824，Log-rank < 0.001；HR = 0.631，95%CI：0.486 - 0.820，Log-rank < 0.001）。肌肉减少症、最大肿瘤直径和甲胎蛋白≥200 ng/mL是OS和PFS的独立危险因素。基于肌肉减少症、甲胎蛋白≥200 ng/mL和最大肿瘤直径≥8.9 cm的预后风险分级系统显示，风险组之间的预后存在显著差异。肌肉减少症对TACE术后患者的OS和PFS具有良好的预测价值，甲胎蛋白≥200 ng/mL和最大肿瘤直径也是预后不良的独立危险因素。基于肌肉减少症、甲胎蛋白和最大肿瘤直径的预后风险分级系统对患者的预后具有良好的指导价值。
