Department of Interventional Therapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China.
Department of Cardiology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China.
J Cancer Res Ther. 2024 Aug 1;20(4):1208-1213. doi: 10.4103/jcrt.jcrt_2451_23. Epub 2024 Aug 29.
Loss of skeletal muscle volume is an important aspect of sarcopenia in hepatocellular carcinoma (HCC) patients treated by surgical resection, transcatheter arterial chemoembolization (TACE), or sorafenib.
This study determined the influence of sarcopenia and other laboratory results on survival in patients with HCC treated with TACE plus sorafenib.
The patients were divided into two groups based on the presence of sarcopenia. The skeletal muscle index was calculated by normalizing the cross-sectional muscle area at the L3 level on an abdominal computed tomography scan before embolization according to the patient's height. The clinical characteristics of the two groups were then compared. The progression-free survival (PFS) and overall survival (OS) rates after treatment were determined.
Sarcopenia was present in 75 of the 102 (74%) patients with HCC included in this study. The albumin, prealbumin, and cholinesterase levels were lower in those with sarcopenia. The OS (P = 0.001) and PFS (P = 0.008) were significantly prolonged in the nonsarcopenia group compared to the sarcopenia group. Sarcopenia, ECOG (≥2), and prealbumin (<180 mg/L) were significantly associated with PFS. Sarcopenia, ECOG (≥2), Child-Pugh B, BCLC stage C, prealbumin (<180 mg/L), and cholinesterase (<5,320 U/L) were significantly associated with OS. The prognostic factors for OS included sarcopenia, ECOG (≥2), and cholinesterase (<5,320 U/L), whereas only ECOG (≥2) was identified as a prognostic factor for PFS.
Sarcopenia may be an indicator of poor clinical outcome in patients with HCC receiving TACE plus sorafenib.
在接受手术切除、经导管动脉化疗栓塞（TACE）或索拉非尼治疗的肝细胞癌（HCC）患者中，骨骼肌体积的丧失是肌肉减少症的一个重要方面。
本研究旨在确定肌肉减少症和其他实验室结果对接受 TACE 联合索拉非尼治疗的 HCC 患者生存的影响。
根据栓塞前腹部 CT 扫描中 L3 水平的横截面积与患者身高的比值，将患者分为两组，有无肌肉减少症。比较两组患者的临床特征。确定治疗后的无进展生存期（PFS）和总生存期（OS）。
本研究纳入的 102 例 HCC 患者中，74%（75 例）存在肌肉减少症。伴有肌肉减少症的患者白蛋白、前白蛋白和胆碱酯酶水平较低。与肌肉减少症组相比，无肌肉减少症组的 OS（P=0.001）和 PFS（P=0.008）显著延长。肌肉减少症、ECOG（≥2）和前白蛋白（<180mg/L）与 PFS 显著相关。肌肉减少症、ECOG（≥2）、Child-Pugh B、BCLC 分期 C、前白蛋白（<180mg/L）和胆碱酯酶（<5,320U/L）与 OS 显著相关。OS 的预后因素包括肌肉减少症、ECOG（≥2）和胆碱酯酶（<5,320U/L），而只有 ECOG（≥2）被确定为 PFS 的预后因素。
肌肉减少症可能是接受 TACE 联合索拉非尼治疗的 HCC 患者临床结局不良的一个指标。
