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Transversal psoas muscle thickness measurement is associated with response and survival in patients with HCC undergoing immunotherapy

BACKGROUND: Sarcopenia is a common problem in patients with HCC. We aimed to evaluate the prognostic and predictive value of baseline transversal psoas muscle thickness (TPMT) measurement in patients with HCC undergoing immunotherapy. METHODS: HCC patients treated with programmed death ligand 1–base...

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Detalles Bibliográficos
Autores principales: Scheiner, Bernhard, Lampichler, Katharina, Pomej, Katharina, Beer, Lucian, Balcar, Lorenz, Sartoris, Riccardo, Bouattour, Mohamed, Sidali, Sabrina, Trauner, Michael, Mandorfer, Mattias, Reiberger, Thomas, Scharitzer, Martina, Tamandl, Dietmar, Pinato, David J., Ronot, Maxime, Pinter, Matthias
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10503692/
https://www.ncbi.nlm.nih.gov/pubmed/37708441
http://dx.doi.org/10.1097/HC9.0000000000000261
Descripción
Sumario:BACKGROUND: Sarcopenia is a common problem in patients with HCC. We aimed to evaluate the prognostic and predictive value of baseline transversal psoas muscle thickness (TPMT) measurement in patients with HCC undergoing immunotherapy. METHODS: HCC patients treated with programmed death ligand 1–based therapies between June 2016 and October 2022 at the Vienna General Hospital (n = 80) and the Hôpital Beaujon Clichy (n = 96) were included and followed until April 2023. TPMT at the level of the third lumbar vertebra was measured independently by 2 radiologists to evaluate interreader reliability. TPMT <12 mm/m in men and <8 mm/m in women indicated sarcopenia. RESULTS: Overall, 176 patients (age: 66.3±11.7 y; male: n=143, 81%, Barcelona-Clinic Liver Cancer C: n=121, 69%) were included, of which 131 (74%) exhibited cirrhosis. Interreader agreement for the diagnosis of sarcopenia based on TPMT was 92.6%, and Cohen κ showed a “strong agreement” [κ = 0.84 (95% CI: 0.75–0.92)]. Sarcopenia, present in 58 patients (33%), was associated with shorter median overall survival [7.2 (95% CI: 5.0–9.5) vs. 22.6 (95% CI: 16.4–28.8 months); p < 0.001] and median progression-free survival [3.4 (95% CI: 0.2–6.8) vs. 7.9 (95% CI: 5.8–9.9 months), p = 0.001], and an independent predictor of overall [adjusted HR: 1.63 (95% CI: 1.07–2.48)] and progression-free mortality [adjusted HR: 1.54 (95% CI: 1.06–2.23)] in multivariable analyses. The objective response rate [evaluable in 162 subjects (92.0%)] per modified Response Evaluation Criteria In Solid Tumors (mRECIST) in patients with and without sarcopenia was 22% and 39%, respectively (p = 0.029). Survival and radiological responses were worse in patients with sarcopenia and systemic inflammation [median overall survival: 6.1 (95% CI: 3.6–8.6) mo; median progression-free survival: 2.8 (95% CI: 2.1–3.4) mo; objective response rate=16%; disease control rate=39%]. CONCLUSIONS: Evaluation of sarcopenia using TPMT measurement is reliable and identifies HCC patients with a dismal prognosis and response to immunotherapy.