Muscle volume loss as a prognostic marker in hepatocellular carcinoma patients treated with sorafenib

Hiraoka, Atsushi; Hirooka, Masashi; Koizumi, Yohei; Izumoto, Hirofumi; Ueki, Hidetaro; Kaneto, Miho; Kitahata, Shogo; Aibiki, Toshihiko; Tomida, Hideomi; Miyamoto, Yuji; Yamago, Hiroka; Suga, Yasuhiro; Iwasaki, Ryuichiro; Mori, Kenichiro; Miyata, Hideki; Tsubouchi, Eiji; Kishida, Masato; Nakamura, Tomoyuki; Abe, Masanori; Matsuura, Bunzo; Kawasaki, Hideki; Hiasa, Yoichi; Michitaka, Kojiro

doi:10.1111/hepr.12780

Cited by 88 publications

(131 citation statements)

References 31 publications

Supporting

Mentioning

118

Contrasting

Unclassified

Order By: Relevance

“…This result indicated that these malnutritional factors were important for the survival of patients with HCC treated with sorafenib. Several recent reports indicated that decreased skeletal muscle mass was an important prognostic factor in patients with chronic liver disease and HCC (2,3,5,6). These results suggested that preventing reductions in skeletal muscle thickness may improve the OS of patients treated with sorafenib.…”

Section: Discussionmentioning

confidence: 91%

“…Recently, an increasing number of studies have demonstrated that sarcopenia may affect the clinical state of patients with liver disease (1)(2)(3). Moreover, skeletal muscle wasting assessed by CT has been reported to be a prognostic marker for patients with hepatocellular carcinoma (HCC) treated with sorafenib (5,6). In those reports, skeletal muscle mass was usually measured by imaging modalities, such as CT and magnetic resonance imaging.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Significance of psoas muscle thickness as an indicator of muscle atrophy in patients with hepatocellular carcinoma treated with sorafenib

Yamashima

Miyaaki

Honda

et al. 2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

Abstract. Sarcopenia has been reported to be associated with the prognosis of patients with liver cirrhosis and hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sarcopenia was associated with the prognosis of patients with HCC treated with sorafenib. A total of 40 patients with HCC who were treated with sorafenib were evaluated. As an indicator of skeletal muscle mass, transverse psoas muscle thickness (TPMT) was measured on computed tomography images at the level of the umbilicus prior to treatment initiation and after 1-3 months of treatment. Pre-TPMT/height was not associated with progression-free survival (PFS) or overall survival (OS). The change in TPMT/height prior to and following treatment was also not associated with PFS; however, the change of TPMT/height was an independent factor affecting OS (P=0.020). A total of 40 patients were divided into two groups depending on the degree of TPMT/height loss (mild and severe muscle atrophy groups). Patients with mild muscle atrophy exhibited a significantly longer OS compared with patients with severe muscle atrophy (P=0.045). Thus, the change in skeletal muscle thickness calculated as TPMT/height may be a simple predictor of survival for patients with HCC treated with sorafenib.

show abstract

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Significance of psoas muscle thickness as an indicator of muscle atrophy in patients with hepatocellular carcinoma treated with sorafenib

Yamashima

Miyaaki

Honda

et al. 2017

Molecular and Clinical Oncology

View full text Add to dashboard Cite

show abstract

“…Although sarcopenia has been reported to be an independent predictor of survival in patients with various cancers including HCC [11-15], there have been only three studies on HCC patients treated with sorafenib [16-18]. However, there have been no studies focusing on both skeletal muscle and visceral fat in HCC patients treated with sorafenib.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, sarcopenia has been reported to be an independent predictor of survival in patients with lung, gastrointestinal, pancreatic, and colorectal cancer as well as HCC [11-15]. For HCC patients receiving sorafenib therapy, it has been reported that skeletal muscle depletion is an independent prognostic factor [16-18]. However, visceral fat area (VFA) is a controversial topic regarding its effects on survival of patients with HCC [15, 19-21].…”

Section: Introductionmentioning

confidence: 99%

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

et al. 2018

View full text Add to dashboard Cite

Background: Sorafenib is a standard therapy for patients with advanced hepatocellular carcinoma (HCC). However, no predictive biomarkers of sorafenib efficacy have been discovered. Herein, we investigated the impact of body composition, such as skeletal muscle and visceral fat, on the prognosis of advanced HCC patients treated with sorafenib. Methods: We enrolled 100 patients with advanced HCC treated with sorafenib. Prior to receiving sorafenib therapy, skeletal muscle index (SMI) and visceral fat area (VFA) were measured using computed tomography at the third lumbar vertebra and umbilical level, respectively. Muscle depletion was defined as an SMI value < 42 cm²/m² in men and < 38 cm²/m² in women. High VFA (H-VFA) was defined as a value ≥100 cm². In addition to SMI and VFA, we also analyzed various clinical parameters as potential prognostic factors. Results: Multivariate analysis showed that having a tumor number < 7 (hazard ratio [HR] = 0.409, p < 0.001), absence of extrahepatic spread (EHS) (HR = 0.562, p < 0.001), absence of muscle depletion (HR = 0.498, p = 0.006), and H-VFA (HR = 0.556, p = 0.031) were significant factors for long-term survival. Therefore, we evaluated the prognosis of those with no muscle depletion with H-VFA. The no muscle depletion with H-VFA group showed significantly longer survival than the other group (median survival time 15.6 vs. 11.0 months, p = 0.003). Multivariate analysis showed that having a tumor number < 7 (HR = 0.454, p = 0.001), absence of EHS (HR = 0.511, p = 0.008), and no muscle depletion with H-VFA (HR = 0.454, p = 0.002) were significant predictors of survival. Conclusions: We identified no muscle depletion with H-VFA as a novel biomarker for advanced HCC patients treated with sorafenib.

show abstract

“…[11][12][13][14][15] Its presence has also been associated with increased toxicity in patients with HCC treated with sorafenib 16 and reduced survival, but the few data available come mainly from oriental series, where ethnic and anthropometric differences limit reproducibility in a Western setting. [17][18][19] Only one Western study is available, with a limited number of patients treated with various tyrosine kinase inhibitors. 20 The aim of the present study was to identify the prevalence and influence of sarcopenia in a homogeneous population of European Caucasian patients with advanced HCC undergoing sorafenib therapy.…”

Section: Introductionmentioning

confidence: 99%

Sarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment

et al. 2018

View full text Add to dashboard Cite

Background: Sarcopenia has been associated with poor outcomes in patients with cirrhosis and solid tumours. Objective: Analyse the influence of sarcopenia on survival and treatment duration in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib. Methods: We conducted a multicentre, retrospective study on 96 patients with advanced HCC treated with sorafenib, all with available abdominal computed tomography (CT) scan within 30 days from treatment start. Anthropometric, laboratory, treatment and follow-up data were collected. Sarcopenia was defined by reduced skeletal muscle index calculated from an L3 section CT image. Results: Sarcopenia was present in 49% of patients. Patients were divided into two groups according to sarcopenia: age was significantly higher in the sarcopenic group (SG) (66 years (31-87) versus 72 years (30-84), p ¼ 0.04], with no difference in other baseline characteristics. The SG showed shorter overall survival (OS) (39 (95% confidence interval (CI) 26-50) versus 61 (95% CI 47-77) weeks (p ¼ 0,01)) and shorter time on treatment (12.3 (95% CI 8-19) versus 25.9 (95% CI 15-33) weeks (p ¼ 0.0044)). At multivariate analysis, sarcopenia was independently associated to reduced OS (p ¼ 0.03) and reduced time on treatment (p ¼ 0.001). Conclusion: Sarcopenia is present in almost half of patients with advanced HCC, and is associated with reduced survival and reduced duration of oral chemotherapy.

show abstract

Muscle volume loss as a prognostic marker in hepatocellular carcinoma patients treated with sorafenib

Abstract: Muscle wasting is an important prognostic factor in patients treated with sorafenib.

Cited by 88 publications

References 31 publications

Significance of psoas muscle thickness as an indicator of muscle atrophy in patients with hepatocellular carcinoma treated with sorafenib

Significance of psoas muscle thickness as an indicator of muscle atrophy in patients with hepatocellular carcinoma treated with sorafenib

No Muscle Depletion with High Visceral Fat as a Novel Beneficial Biomarker of Sorafenib for Hepatocellular Carcinoma

Sarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment

Contact Info

Product

Resources

About