BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assess...BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-embolization.METHODS Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were included.Sarcopenia was assessed using skeletal muscle index at baseline and at the first radiological assessment.Radiological response was recorded after the first session of treatment using mRECIST.RESULTS Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,respectively.Sarcopenia was present in 57.7%of the patients.Patients with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic patients.Finally,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.展开更多
基金The study was conducted according to the guidelines of the Declaration of Helsinki.Study ethics was approved by the independent French ethic committee CERIM(Comitéd’éthique de la recherche en imagerie médicale)(approval date May 252020,No.CRM-2004-084).
文摘BACKGROUND At the diagnosis of hepatocellular carcinoma(HCC),more than 90%of HCC patients present cirrhosis,a clinical condition often associated to malnutrition.Sarcopenia is an indirect marker of malnutrition assessable on computed tomography(CT).AIM To evaluate the prognostic value of sarcopenia in patients with HCC treated by trans-arterial(chemo)-embolization.METHODS Patients with HCC treated by a first session of trans-arterial(chemo)embolization and an available CT scan before treatment were included.Sarcopenia was assessed using skeletal muscle index at baseline and at the first radiological assessment.Radiological response was recorded after the first session of treatment using mRECIST.RESULTS Of 225 patients treated by trans-arterial bland embolization(n=71)or trans-arterial chemoembolization(n=154)for HCC between 2007 and 2013,Barcelona Clinic of Liver Cancer stage was A,B,and C in 27.5%,55%,and 16.8%of cases,respectively.Sarcopenia was present in 57.7%of the patients.Patients with sarcopenia presented a higher rate of progressive disease(19%vs 8%,P=0.0236),a shorter progression-free survival(8.3 vs 13.2 mo,P=0.0035),and a shorter median overall survival(19.4 mo vs 35.5 mo,P=0.0149)compared with non-sarcopenic patients.Finally,patients whose sarcopenia appeared after first transarterial treatment had the worst prognosis(P=0.0004).CONCLUSION Sarcopenia is associated with tumor progression and poor survival outcomes after trans-arterial(chemo)-embolization for HCC.
