Combination of psoas muscle mass index and neutrophil/lymphocyte ratio as a prognostic predictor for patients undergoing nonsurgical hepatocellular carcinoma therapy

Abstract

Background and Aim: Reliable predictors for hepatocellular carcinoma (HCC) are urgently needed. The psoas muscle index (PMI) is a simple and rapid method for evaluating muscle atrophy. Furthermore, the neutrophil/lymphocyte ratio (NLR) is a prognostic factor that is easy to calculate in everyday clinical practice. We aimed to investigate the value of the PMI and NLR as prognostic factors for patients receiving nonsurgical HCC therapy, hepatic arterial infusion chemotherapy (HAIC), transcatheter arterial chemoembolization (TACE), or molecular targeted drugs such as sorafenib (SOR) and lenvatinib (LEN). Methods: We enrolled 87 patients with HCC who were treated with HAIC, TACE, SOR, or LEN. The primary endpoint was overall survival (OS) with variable PMI or NLR status. For Barcelona Clinic Liver Cancer (BCLC)-B patients, useful prognostic factors were examined by comparing the OS between stratified groups. Prognostic factors including PMI and NLR were evaluated by univariate and multivariate analysis.Results: Analysis of HAIC or TACE (HAIC/TACE) and SOR or LEN (SOR/LEN) patients showed significant differences in OS between low and high PMI. In patients treated with TACE, there was a significant difference in OS between low and high NLR. For BCLC-B and low PMI, the prognosis was significantly worse for SOR/LEN than for TACE, although there was no difference for high PMI, suggesting that PMI may be useful for treatment selection. In addition, the prognostic formula composed of PMI, NLR, and up-to-seven criteria developed in the present study may be useful. Conclusion: PMI and NLR are considered to be independent prognostic factors for HCC.

Association between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma: an updated meta-analysis

“…The association between OS and sarcopenia was reported in 51 studies 3 , 23 – 34 , 36 , 38 – 43 , 45 – 71 , 73 – 76 involving 8768 patients. Considering the high heterogeneity (I 2 = 54%), a random effects model was used for analysis (Fig.…”

“…A total of 57 studies involving 9790 HCC patients were included in the meta-analysis. The studies were conducted in different regions, with 41 studies 3 , 24 , 26 – 28 , 32 – 37 , 39 – 41 , 43 – 51 , 54 – 60 , 62 , 63 , 66 – 69 , 71 , 73 – 76 (Japan provided the largest volume of studies, followed by the South Korea) from Asia, and 16 studies 21 – 23 , 25 , 29 – 31 , 38 , 42 , 52 , 53 , 61 , 64 , 65 , 70 , 72 conducted in non-Asia regions. The enrolled patients covered all stages of HCC (from BCLC stage 0/A to BCLC stage D) and the corresponding treatments (RFA, hepatectomy, LDLT, TACE, TARE, radiotherapy, sorafenib, lenvatinib, and ICIs).…”

“…Sarcopenia was diagnosed through CT or (MRI) in all studies. Two studies 3 , 71 included only males and three studies identified sarcopenia using the change of muscle mass after or during treatment. Among all included studies, different diagnostic methods and cut‐off values were utilized to identify sarcopenia, with the skeletal mass index (SMI) being the most commonly used method.…”

“…A total of 57 studies involving 9790 HCC patients were included in the meta-analysis. The studies were conducted in different regions, with 41 studies 3,24,[26][27][28][32][33][34][35][36][37][39][40][41][43][44][45][46][47][48][49][50][51][54][55][56][57][58][59][60]62,63,[66][67][68][69]71,[73][74][75][76] (Japan provided the largest volume of studies, followed by the South Korea) from Asia, and 16 studies [21][22][23]25,[29][30][31]38,42,…”

Preoperative psoas muscle index a modern prognostic factor in the follow-up of patients with rectal cancer who underwent surgery

“…A sarcopenia prognosztikai szerepét több tanulmány is alátámasztotta, valamint azt, hogy szignifikáns összefüggés van ezen szindróma kialakulása és különböző malignus daganatok kedvezőtlen kimenetele között [10,15]. A sarcopeniát több típusú malignus daganatos betegség esetében megfigyelték, mint nyelőcső- [9,19,20], gyomor- [9,10,21,22], vese- [23], húgyhólyag- [9], máj- [10,24], hasnyálmirigy- [9,10,25], emlő- [9], és tüdőrák [9,26]. Egy áttekintő tanulmányban preoperatív CT segítségével vizsgálták a csökkent vázizomzat tömegét és összefüggést találtak a sarcopenia és a kedvezőtlen prognózis között gastrointestinalis és hepatopancreatobiliaris malignus daganatok esetében [27].…”