Rapidly declining skeletal muscle mass predicts poor prognosis of hepatocellular carcinoma treated with transcatheter intra-arterial therapies

• Published in: BMC cancer 2018-07, Vol.18 (1), p.756-756, Article 756
• Main Authors: Kobayashi, Takamasa, Kawai, Hirokazu, Nakano, Oki, Abe, Satoshi, Kamimura, Hiroteru, Sakamaki, Akira, Kamimura, Kenya, Tsuchiya, Atsunori, Takamura, Masaaki, Yamagiwa, Satoshi, Terai, Shuji
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic; Female; Hepatocellular carcinoma; Humans; Infusions, Intra-Arterial; Liver Neoplasms - mortality; Liver Neoplasms - therapy; Male; Middle Aged; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - pathology; Prognosis; Proportional Hazards Models; Retrospective Studies; Sarcopenia; Sarcopenia - epidemiology; Sarcopenia - prevention & control; Skeletal muscle loss; Transcatheter arterial chemoembolization; Transcatheter arterial infusion chemotherapy
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-018-4673-2

The impact of sarcopenia on the prognosis of patients with hepatocellular carcinoma (HCC) who receive transcatheter intra-arterial therapies, including transcatheter arterial chemoembolization and transcatheter arterial infusion chemotherapy, remains unclear. We investigated the prognostic value of skeletal muscle loss (SML) stratified by cutoffs for sarcopenia and rate of change in skeletal muscle mass over 6 months. We retrospectively evaluated 102 patients with HCC treated with transcatheter intra-arterial therapies between 2005 and 2015. Computed tomography images of the third lumbar vertebra (L3) were analyzed to obtain the skeletal muscle area normalized for the height squared, defined as the skeletal muscle index at L3 (L3 SMI), before and 6 months after treatment. Low or high SMI was defined using cutoff values of 42 cm /m in men and 38 cm /m in women. The rate of change in skeletal muscle mass (ΔL3 SMI) over 6 months was calculated. Overall survival (OS) was compared in groups classified by baseline L3 SMI and ΔL3 SMI; prognostic significance was assessed with univariate and multivariate analyses, using Cox proportional hazards models. OS did not differ significantly between groups with low (n = 31) and high (n = 71) SMI at baseline (P = 0.172), but OS was significantly poorer in patients with SML (n = 41), defined as ΔL3 SMI