肌肉减少症对肝细胞癌患者腹腔镜根治术后预后的影响

Effect of sarcopenia on the prognosis of patients with hepatocellular carcinoma after laparoscopic radical surgery

目的分析肌肉减少症对肝细胞癌患者腹腔镜根治术后预后的影响。方法回顾分析2018年1月至2021年12月河南大学人民医院行腹腔镜根治术的165例肝细胞癌患者资料,其中男性122例,女性43例,年龄(55.5±11.4)岁。依据骨骼肌指数将患者分为肌肉减少症组(n=79)与对照组(n=86,无肌肉减少症)。Kaplan-Meier法分析生存情况,生存率比较采用log-rank检验。单因素和多因素Cox回归分析肌肉减少症对肝细胞癌患者腹腔镜根治术后预后的影响。结果对照组患者术后1、3年累积生存率分别为96.4%、81.2%,明显高于肌肉减少症组的83.2%、48.9%,差异有统计学意义(χ^(2)=19.67,P<0.001)。对照组患者术后1、3年无复发生存率分别为88.4%、66.1%,高于肌肉减少症组的70.9%、37.7%,差异有统计学意义(χ^(2)=18.80,P<0.001)。多因素Cox回归分析显示,肌肉减少症的肝细胞癌患者腹腔镜根治术后复发风险(HR=1.35,95%CI:1.20~1.59,P<0.001)和死亡风险(HR=2.21,95%CI:1.23~3.41,P=0.001)相较于非肌肉减少症患者增加。结论肌肉减少症是肝细胞癌患者腹腔镜根治术后生存和复发的危险因素。

ObjectiveTo analyze the effect of sarcopenia on the prognosis of patients with hepatocellular carcinoma(HCC)after laparoscopic radical resection.MethodsClinical data of 165 patients with HCC undergoing laparoscopic radical resection in Henan University People's Hospital from January 2018 to December 2021 were retrospectively analyzed,including 122 males and 43 females,aged(55.5±11.4)years.Patients were divided into sarcopenia group(n=79)and control group(non-sarcopenia,n=86)according to the skeletal muscle index.The survivals were analyzed using the Kaplan-Meier method,and were compared by the log-rank test.Univariate and multivariate Cox regression were utilized to analyze the effect of sarcopenia on the prognosis of HCC after laparoscopic radical surgery.ResultsThe 1-and 3-year cumulative survival rates of control group were 96.4%and 81.2%,which were higher than those of the sarcopenia group(83.2%and 48.9%,respectively,χ^(2)=19.67,P<0.001).The 1-and 3-year recurrence-free survival(RFS)rates of control group were 88.4%and 66.1%,which were higher than those of sarcopenia group(70.9%and 37.7%,respectively,χ^(2)=18.80,P<0.001).Multivariate Cox regression analysis showed that the risk of recurrence(HR=1.35,95%CI:1.20-1.59,P<0.001)and the risk of death(HR=2.21,95%CI:1.23-3.41,P=0.001)after laparoscopic radical resection for HCC in patients with sarcopenia rises compared to non-sarcopenic patients.ConclusionSarcopenia is a risk factor for the survival and recurrence of HCC after laparoscopic radical surgery.