Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Impact of sarcopenia on long-term outcomes in hepatocellular carcinoma treated with trans-arterial radioembolization: A retrospective multi-center study

Heechul Nam
ORCID logo ,
Hyun Yang
ORCID logo ,
Ho Soo Chun
,
Han Ah Lee
ORCID logo ,
Joon Yeul Nam
,
Jeong Won Jang
ORCID logo ,
Yeon Seok Seo
,
Do Young Kim
ORCID logo ,
Yoon Jun Kim
ORCID logo ,
Si Hyun Bae
* ORCID logo
Version 1 : Received: 25 September 2023 / Approved: 25 September 2023 / Online: 26 September 2023 (08:22:48 CEST)

A peer-reviewed article of this Preprint also exists.

Nam, H.; Yang, H.; Chun, H.S.; Lee, H.A.; Nam, J.Y.; Jang, J.W.; Seo, Y.S.; Kim, D.Y.; Kim, Y.J.; Bae, S.H. Impact of Low Skeletal Muscle Mass on Long-Term Outcomes in Hepatocellular Carcinoma Treated with Trans-Arterial Radioembolization: A Retrospective Multi-Center Study. Cancers 2023, 15, 5195. Nam, H.; Yang, H.; Chun, H.S.; Lee, H.A.; Nam, J.Y.; Jang, J.W.; Seo, Y.S.; Kim, D.Y.; Kim, Y.J.; Bae, S.H. Impact of Low Skeletal Muscle Mass on Long-Term Outcomes in Hepatocellular Carcinoma Treated with Trans-Arterial Radioembolization: A Retrospective Multi-Center Study. Cancers 2023, 15, 5195.

Abstract

Trans-arterial radioembolization (TARE) is a form of radiation therapy performed for hepatocellular carcinoma (HCC) via selective intra-arterial injection of Yttrium-90 loaded microspheres. This was a multicenter retrospective study of consecutive patients with HCC who underwent TARE between July 2009 and May 2019. Using pre-treatment computed tomography imaging, the total cross-sectional area (cm2) of the abdominal skeletal muscle at the third lumbar vertebra was measured. The skeletal muscle index (SMI) was calculated by normalizing the muscle area to patient height. In total, 347 patients (median age, 65 years; 284 male) were included in the study. A total of 108 (31.1%) patients had portal vein tumor thrombus (PVTT) and 126 (36.3%) were classified as sarcopenic. The median overall survival (OS) was 28.1 months (95% CI, 24.8-35.7) and median progression-free survival was 8.0 months (95% CI, 6.4-9.4). Multivariate Cox regression analysis revealed that sarcopenia (hazard ratio [HR], 1.36; 95% CI, 1.00-1.85, p = 0.05), PVTT (HR, 1.82; 95% CI, 1.33-2.49, p < 0.01), alpha-fetoprotein (AFP) (≥200 ng/mL) (HR 1.41; 95% CI, 1.04-1.92, p = 0.03), and albumin-bilirubin grade (2-3) (HR 1.74; 95% CI, 1.24-2.43, p < 0.01) were independently associated with poor OS. TARE provided favorable long-term outcomes for patients with advanced HCC. Pre-treatment sarcopenia independently associated with survival, suggesting its utility as a surrogate biomarker for identifying TARE candidates.

Keywords

Hepatocellular carcinoma; Transarterial radioembolization; Yttrium-90; Locoregional treatment; Portal vein tumor thrombosis; Overall survival; Progression-free survival; Skeletal muscle mass; Sarcopenia; Body mass index.

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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