Cargando…

Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy

SIMPLE SUMMARY: Although reduced skeletal muscle mass affects therapeutic efficacy and adverse events in various therapies for hepatocellular carcinoma (HCC), there are no reports on skeletal muscle mass or its changes and prognostic indications in patients with advanced HCC undergoing hepatic arter...

Descripción completa

Detalles Bibliográficos
Autores principales: Oura, Kyoko, Morishita, Asahiro, Tani, Joji, Nomura, Takako, Manabe, Takushi, Takuma, Kei, Nakahara, Mai, Tadokoro, Tomoko, Fujita, Koji, Mimura, Shima, Sanomura, Takayuki, Nishiyama, Yoshihiro, Masaki, Tsutomu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047018/
https://www.ncbi.nlm.nih.gov/pubmed/36980720
http://dx.doi.org/10.3390/cancers15061834
_version_ 1785013816775409664
author Oura, Kyoko
Morishita, Asahiro
Tani, Joji
Nomura, Takako
Manabe, Takushi
Takuma, Kei
Nakahara, Mai
Tadokoro, Tomoko
Fujita, Koji
Mimura, Shima
Sanomura, Takayuki
Nishiyama, Yoshihiro
Masaki, Tsutomu
author_facet Oura, Kyoko
Morishita, Asahiro
Tani, Joji
Nomura, Takako
Manabe, Takushi
Takuma, Kei
Nakahara, Mai
Tadokoro, Tomoko
Fujita, Koji
Mimura, Shima
Sanomura, Takayuki
Nishiyama, Yoshihiro
Masaki, Tsutomu
author_sort Oura, Kyoko
collection PubMed
description SIMPLE SUMMARY: Although reduced skeletal muscle mass affects therapeutic efficacy and adverse events in various therapies for hepatocellular carcinoma (HCC), there are no reports on skeletal muscle mass or its changes and prognostic indications in patients with advanced HCC undergoing hepatic arterial infusion chemotherapy (HAIC). This is the first study to show the association between the presence of a decreased skeletal muscle index (SMI) and clinical outcomes in HAIC, with novel evidence having a strong impact. A decrease in the SMI immediately after the start of HAIC was significantly associated with poor progression-free survival and overall survival in patients with advanced HCC, whereas the pre-treatment SMI was not a significant factor. Additionally, patients with a decreased SMI after treatment had worse nutritional status and liver function and poor therapeutic effects. It is effective to monitor the SMI and evaluate the therapeutic effects by using computed tomography to evaluate general conditions and predict clinical outcomes. ABSTRACT: Sarcopenia-related factors, including the skeletal muscle index (SMI), are reportedly associated with prognosis in patients with hepatocellular carcinoma (HCC) receiving various treatments. However, there is no evidence relating to hepatic arterial infusion chemotherapy (HAIC). In this study, we investigated whether a low SMI was associated with worse clinical outcomes of HAIC. Seventy patients with advanced HCC were included. Clinical outcomes were compared between the decreased SMI (n = 27) and non-decreased SMI (n = 43) groups, which were classified according to changes in the SMI after 3 weeks of treatment. In the prognostic analysis, patients in the decreased SMI group had significantly shorter progression-free and overall survival (OS) than those in the non-decreased SMI group. In addition, poor nutritional status and liver function were associated with an immediate decrease in the SMI after HAIC. The therapeutic effect was worse in the decreased SMI group than in the non-decreased SMI group, although the incidence of adverse events did not significantly differ. In multivariate analysis, a decreased SMI at 3 weeks after HAIC was identified as a significant independent factor associated with OS. A decreased SMI in patients with advanced HCC undergoing HAIC was associated with poor prognosis. It is effective to monitor the SMI to evaluate general conditions and predict clinical outcomes.
format Online
Article
Text
id pubmed-10047018
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100470182023-03-29 Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy Oura, Kyoko Morishita, Asahiro Tani, Joji Nomura, Takako Manabe, Takushi Takuma, Kei Nakahara, Mai Tadokoro, Tomoko Fujita, Koji Mimura, Shima Sanomura, Takayuki Nishiyama, Yoshihiro Masaki, Tsutomu Cancers (Basel) Article SIMPLE SUMMARY: Although reduced skeletal muscle mass affects therapeutic efficacy and adverse events in various therapies for hepatocellular carcinoma (HCC), there are no reports on skeletal muscle mass or its changes and prognostic indications in patients with advanced HCC undergoing hepatic arterial infusion chemotherapy (HAIC). This is the first study to show the association between the presence of a decreased skeletal muscle index (SMI) and clinical outcomes in HAIC, with novel evidence having a strong impact. A decrease in the SMI immediately after the start of HAIC was significantly associated with poor progression-free survival and overall survival in patients with advanced HCC, whereas the pre-treatment SMI was not a significant factor. Additionally, patients with a decreased SMI after treatment had worse nutritional status and liver function and poor therapeutic effects. It is effective to monitor the SMI and evaluate the therapeutic effects by using computed tomography to evaluate general conditions and predict clinical outcomes. ABSTRACT: Sarcopenia-related factors, including the skeletal muscle index (SMI), are reportedly associated with prognosis in patients with hepatocellular carcinoma (HCC) receiving various treatments. However, there is no evidence relating to hepatic arterial infusion chemotherapy (HAIC). In this study, we investigated whether a low SMI was associated with worse clinical outcomes of HAIC. Seventy patients with advanced HCC were included. Clinical outcomes were compared between the decreased SMI (n = 27) and non-decreased SMI (n = 43) groups, which were classified according to changes in the SMI after 3 weeks of treatment. In the prognostic analysis, patients in the decreased SMI group had significantly shorter progression-free and overall survival (OS) than those in the non-decreased SMI group. In addition, poor nutritional status and liver function were associated with an immediate decrease in the SMI after HAIC. The therapeutic effect was worse in the decreased SMI group than in the non-decreased SMI group, although the incidence of adverse events did not significantly differ. In multivariate analysis, a decreased SMI at 3 weeks after HAIC was identified as a significant independent factor associated with OS. A decreased SMI in patients with advanced HCC undergoing HAIC was associated with poor prognosis. It is effective to monitor the SMI to evaluate general conditions and predict clinical outcomes. MDPI 2023-03-18 /pmc/articles/PMC10047018/ /pubmed/36980720 http://dx.doi.org/10.3390/cancers15061834 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Oura, Kyoko
Morishita, Asahiro
Tani, Joji
Nomura, Takako
Manabe, Takushi
Takuma, Kei
Nakahara, Mai
Tadokoro, Tomoko
Fujita, Koji
Mimura, Shima
Sanomura, Takayuki
Nishiyama, Yoshihiro
Masaki, Tsutomu
Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title_full Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title_fullStr Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title_full_unstemmed Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title_short Prognostic Value of Skeletal Muscle Loss in Patients with Hepatocellular Carcinoma Treated with Hepatic Arterial Infusion Chemotherapy
title_sort prognostic value of skeletal muscle loss in patients with hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047018/
https://www.ncbi.nlm.nih.gov/pubmed/36980720
http://dx.doi.org/10.3390/cancers15061834
work_keys_str_mv AT ourakyoko prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT morishitaasahiro prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT tanijoji prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT nomuratakako prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT manabetakushi prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT takumakei prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT nakaharamai prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT tadokorotomoko prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT fujitakoji prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT mimurashima prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT sanomuratakayuki prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT nishiyamayoshihiro prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy
AT masakitsutomu prognosticvalueofskeletalmusclelossinpatientswithhepatocellularcarcinomatreatedwithhepaticarterialinfusionchemotherapy