Ann Clin Nutr Metab.  2021 Dec;13(2):62-67. 10.15747/ACNM.2021.13.2.62.

Clinical Significance of Sarcopenia in Patients with Advanced Hepatocellular Carcinoma Undergoing Sorafenib Treatment

• KMID: 2524536
• DOI: http://doi.org/10.15747/ACNM.2021.13.2.62

Abstract

Purpose
Sarcopenia has been associated with poor outcomes in patients with cirrhosis and solid tumors. However, information is limited on the prevalence and significance of sarcopenia in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. In the present study, we investigated the prognostic value of sarcopenia in patients with advanced HCC, treated with sorafenib after stratification by standard prognostic factors.
Materials and Methods
We enrolled 85 patients (77 males and 8 females) treated with sorafenib from August 2007 to August 2016. The bilateral psoas muscle area at the L3 vertebral level was measured from computed tomography images, just before sorafenib administration. This area was normalized by patients’ height, using units described in mm² /m² . Patients were classified into sarcopenia and non-sarcopenia groups using a cutoff value of 575.8 mm² /m² .
Results
The 3-year overall survival rate was 22.4%. Univariate analysis revealed the presence of sarcopenia (P=0.001), a baseline alpha-fetoprotein level of ≥100 ng/ml (P=0.022), derived neutrophil-to-lymphocyte ratio (P=0.019), and platelet-to-lymphocyte ratio (P=0.003) to be independent prognostic factors. In multivariate analysis, sarcopenia was independently associated with reduced overall survival (P=0.043). However, sarcopenia was not associated with reduced time on treatment.
Conclusion
In sorafenib treatment for advanced HCC, sarcopenia may be a significant prognostic factor and is associated with reduced survival.

Keyword

Hepatocelluar carcinoma; Prognostic factor; Sarcopenia