Effect of Sarcopenia on Survival and Health-Related Quality of Life in Patients with Hepatocellular Carcinoma after Hepatectomy

SIMPLE SUMMARY: Although sarcopenia reduces the quality of life in the general population, there is a lack of prospective cohorts in HCC patients to explore this relationship. We performed a prospective study to compare postoperative 1-year mortality and health-related quality of life after HCC resection between patients with and without sarcopenia. Our analyses revealed that patients with sarcopenia had a greater disease burden, which affected short-term postoperative survival rates and quality of life. Our study is the first step in exploring the relationship between sarcopenia and postoperative lifestyle in patients with liver cancer, which will further promote the implementation of preoperative sarcopenia assessment in patients with hepatocellular carcinoma. ABSTRACT: Background: Although sarcopenia has been reported as a negative prognostic factor in patients with hepatocellular carcinoma (HCC), the lack of studies with a prospective design utilizing comprehensive sarcopenia assessment with composite endpoints is an important gap in understanding the impact of sarcopenia in patients with HCC. The aim of this study was to investigate the relationship between sarcopenia and postoperative 1-year mortality and health-related quality of life (HRQOL) based on sarcopenia assessment. Methods: The study cohort, who received resection surgery for HCC between May 2020 and August 2021, was assessed for sarcopenia based on grip strength, the chair stand test, skeletal muscle mass, and gait speed. The primary outcome measures were 1-year mortality and HRQOL determined using the QLQ-C30 questionnaire. In addition, we collected hospital costs, postoperative hospital stays, complications, 30-day and 90-day mortality, and 90- and 180-day readmission rates. Univariate and multivariate linear regression analyses were conducted to examine factors associated with global health status. Results: A total of 153 eligible patients were included in the cohort. One-year mortality was higher in patients with sarcopenia than in those without sarcopenia (p = 0.043). There was a correlation between sarcopenia and the surgical approach to global health status (p = 0.025) and diarrhea (p = 0.003). Conclusions: Preoperative sarcopenia reduces postoperative survival and health-related quality of life in patients with HCC.