Sarcopenia Predicts Reduced Survival in Patients with Hepatocellular Carcinoma at First Diagnosis

Begini, Paola; Gigante, Elia; Antonelli, Giulio; Carbonetti, Francesco; Iannicelli, Elsa; Anania, Giulia; Imperatrice, Barbara; Pellicelli, A.; Fave, Gianfranco Delle; Marignani, Massimo

doi:10.5604/16652681.1226821

Cited by 60 publications

(48 citation statements)

References 33 publications

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“…This observation confirms the warning that sarcopenia is not exclusively to be sought in patients with low BMI, strengthening the importance and prevalence of sarcopenic obesity. 10,11,15 Our data further contributes to the definition of the role of sarcopenia as a possible predictor of reduced survival and cancer treatment toxicity, as has been previously shown in other oncological settings. 10 Accurate measurement tools are also needed in HCC, and CTbased technologies provide measurable and repeatable muscle mass measurement.…”

Section: Discussionmentioning

confidence: 71%

“…This percentage is in line with those observed among HCC cirrhotic patients and in our previous paper in Caucasian patients with HCC using similar L3 SMI thresholds. 11,15 As expected, sarcopenia was linked to gender and age. A paper from Japan previously reported a higher prevalence of sarcopenia in patients treated with sorafenib (close to 65%), probably linked to different thresholds chosen from Asian series published in the literature, and as suggested by the authors, could be unfit for Caucasian patients.…”

Section: Discussionmentioning

confidence: 76%

“…6 In the field of hepatology, sarcopenia has been linked to reduced survival rates in different therapeutic settings such as liver transplantation, hepatic resection and intra-arterial treatments for HCC. [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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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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.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

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

et al. 2018

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“…As HCC patients with complications such as sarcopenia have poor survival rates when compared to HCC patients without sarcopenia, precise determinations of skeletal muscle mass are very important in directing medical care and predicting patient survival. Multifrequency BIA is a simple, non‐invasive, and widely accepted technique for assessing primary sarcopenia .…”

Section: Discussionmentioning

confidence: 99%

“…When we compared the association between Scre, Scys, eGFRcre, eGFRcys, Scre/Scys ratio, and eGFRcre/eGFRcys ratio with HCC patient survival, we found that the eGFRcre/eGFRcys ratio was the best predictor of OS in HCC patients. In general, tumor‐related factors such as tumor stage and tumor markers, and patient‐related factors such as Child–Pugh grade and sarcopenia, are known predictors of survival in HCC patients. In the present study, the tumor‐related factors BCLC stage and AFP were independent predictors in HCC patients, as we expected.…”

Section: Discussionmentioning

confidence: 99%

Ratio between estimated glomerular filtration rates of creatinine and cystatin C predicts overall survival in patients with hepatocellular carcinoma

Tamai

Iwasa

Kawasaki

et al. 2018

Hepatology Research

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Association of Sarcopenia With Oncologic Outcomes of Primary Surgery or Definitive Radiotherapy Among Patients With Localized Oropharyngeal Squamous Cell Carcinoma

Olson

Edwards

Stone

et al. 2020

JAMA Otolaryngol Head Neck Surg

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The negative association of low lean muscle mass (sarcopenia) with survival outcomes in head and neck cancers, including oropharyngeal carcinoma, is established. However, it is not known whether the choice of primary treatment modality (surgery or radiotherapy) is associated with oncologic outcomes of patients with sarcopenia and oropharyngeal squamous cell carcinoma (OPSCC).OBJECTIVE To examine whether primary surgical resection or definitive radiotherapy is associated with improved survival for patients with sarcopenia and localized OPSCC. DESIGN, SETTING, AND PARTICIPANTSA cohort study was conducted of patients with clinically staged T1 to T2, N0 to N2 OPSCC with cross-sectional abdominal imaging within 60 days prior to treatment and treated between January 1, 2005, and December 31, 2017. Skeletal muscle mass was measured at the third lumbar vertebra using previously defined techniques and sarcopenia was defined as less than 52.4 cm 2 /m 2 of muscle for men and less than 38.5 cm 2 /m 2 for women. In addition, associated patient demographic characteristics, cancer data, treatment information, and survival outcomes were assessed. Statistical analysis was performed from December 3, 2018, to August 28, 2019.MAIN OUTCOMES AND MEASURES Primary outcomes were overall survival and disease-specific survival. RESULTS Among the 245 patients who met study inclusion criteria, 209 were men (85.3%) and the mean (SD) age was 62.3 (7.8) years. Sarcopenia was detected in 135 patients (55.1%), while normal skeletal muscle mass was detected in 110 patients (44.9%). For the 110 patients without sarcopenia, primary treatment modality was not associated with improved survival. For patients with sarcopenia at diagnosis, primary surgical resection was associated with improved overall survival (hazard ratio [HR], 0.37; 95% CI, 0.17-0.82) and disease-specific survival (HR, 0.22; 95% CI, 0.07-0.68). This association persisted after propensity score matching, as up-front surgery was associated with improved overall survival (HR, 0.33; 95% CI, 0.12-0.91) and disease-specific survival (HR, 0.17; 95% CI, 0.04-0.75) survival. CONCLUSIONS AND RELEVANCEThis study suggests that sarcopenia has a negative association with survival for patients with OPSCC. Primary surgery and radiotherapy confer similar survival associations for patients with normal skeletal muscle mass and localized OPSCC. However, up-front surgical resection may be associated with improved survival outcomes for patients with sarcopenia.

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Sarcopenia Predicts Reduced Survival in Patients with Hepatocellular Carcinoma at First Diagnosis

Cited by 60 publications

References 33 publications

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

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

Ratio between estimated glomerular filtration rates of creatinine and cystatin C predicts overall survival in patients with hepatocellular carcinoma

Association of Sarcopenia With Oncologic Outcomes of Primary Surgery or Definitive Radiotherapy Among Patients With Localized Oropharyngeal Squamous Cell Carcinoma

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