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
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DOI：
10.1177/2050640618781188
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发表时间：
2018-08-01
影响因子：
6
通讯作者：
Marignani, Massimo
中科院分区：
文献类型：
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作者：
Antonelli, Giulio;Gigante, Elia;Marignani, Massimo
背景资料：肌肉减少症与肝硬化和实体瘤患者的不良结局相关。目的：分析肌肉减少症对索拉非尼治疗晚期肝细胞癌（HCC）患者的生存率和治疗时间的影响。方法：我们对96例接受索拉非尼治疗的晚期HCC患者进行了一项多中心、回顾性研究，所有患者均在治疗开始后30天内进行腹部计算机断层扫描（CT）。收集人体测量、实验室、治疗和随访数据。结果：49/0的患者存在肌肉减少症。根据肌肉减少症将患者分为两组：肌肉减少症组（SG）的年龄显著较高（66岁（31-87）vs 72岁（30-84），p = 0.04），其他基线特征无差异。SG显示总生存期（OS）较短（39（95%置信区间（CI）26-50）vs 61（95% CI 47-77）周（p = 0.01））和治疗时间较短（12.3（95% CI 8-19）vs 25.9（95% CI 15-33）周（p = 0.0044））。在多变量分析中，肌肉减少症与OS降低（p = 0.03）和治疗时间缩短（p = 0.001）独立相关。结论：肌肉减少症存在于几乎一半的晚期HCC患者中，并且与生存率降低和口服化疗持续时间缩短相关。
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 49/0 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 = 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 = 0,01)) and shorter time on treatment (12.3 (95% CI 8-19) versus 25.9 (95% CI 15-33) weeks (p = 0.0044)). At multivariate analysis, sarcopenia was independently associated to reduced OS (p = 0.03) and reduced time on treatment (p = 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.