Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Anticancer Res. 2024 Sep;44(9):4101-4111. doi: 10.21873/anticanres.17239.
BACKGROUND/AIM: The effects of body mass index (BMI) and body composition on the outcomes of systemic treatment for unresectable hepatocellular carcinoma (uHCC) remain unclear.
In this retrospective study, patients with uHCC treated with lenvatinib (LEN) or atezolizumab+bevacizumab, were classified into high- (≥25 kg/m) and low- (<25 kg/m) BMI groups and evaluated for prognosis. Prognostic impact of body composition was also evaluated.
Patients with a high BMI had lower skeletal mass index (SMI), subcutaneous adipose tissue index (SATI), and visceral adipose tissue index (VATI) compared to those in the low-BMI cohort. The baseline Child-Pugh scores and Barcelona Clinic Liver Cancer stages were comparable between the two cohorts. The overall survival (OS) was better in the high BMI group compared to the low BMI group (median, 913 vs. 484 days; p=0.008). SMI had a strong influence on OS. Additionally, low BMI, VATI, SATI, and visceral-to-subcutaneous fat ratio (VSR) in the LEN treatment group were associated with shorter progression-free survival (PFS).
Following systemic treatment for uHCC, patients with low BMI have a poor prognosis. Among anthropometric factors, low SMI is associated with poor OS. In the LEN treatment group, low VATI may impact PFS negatively.
背景/目的： 体重指数（BMI）和身体成分对不可切除肝细胞癌（uHCC）系统治疗结果的影响尚不清楚。
在这项回顾性研究中，接受仑伐替尼（LEN）或阿替利珠单抗+贝伐珠单抗治疗的 uHCC 患者被分为高（≥25kg/m）和低（<25kg/m）BMI 组，并评估其预后。还评估了身体成分的预后影响。
与低 BMI 队列相比，高 BMI 患者的骨骼质量指数（SMI）、皮下脂肪组织指数（SATI）和内脏脂肪组织指数（VATI）较低。两组患者的基线 Child-Pugh 评分和巴塞罗那临床肝癌分期相当。与低 BMI 组相比，高 BMI 组的总生存期（OS）更好（中位，913 与 484 天；p=0.008）。SMI 对 OS 有很强的影响。此外，在 LEN 治疗组中，低 BMI、VATI、SATI 和内脏-皮下脂肪比（VSR）与较短的无进展生存期（PFS）相关。
在接受 uHCC 系统治疗后，低 BMI 患者的预后较差。在人体测量因素中，低 SMI 与 OS 不良相关。在 LEN 治疗组中，低 VATI 可能对 PFS 产生负面影响。
