Rapid Depletions of Subcutaneous Fat Mass and Skeletal Muscle Mass Predict Worse Survival in Patients with Hepatocellular Carcinoma Treated with Sorafenib
Rapid Depletions of Subcutaneous Fat Mass and Skeletal Muscle Mass Predict Worse Survival in Patients with Hepatocellular Carcinoma Treated with Sorafenib
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DOI：
10.3390/cancers11081206
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发表时间：
2019-08-01
期刊：
影响因子：
5.2
通讯作者：
Shimizu, Masahito
中科院分区：
文献类型：
--
作者：
Imai, Kenji;Takai, Koji;Shimizu, Masahito
本研究的目的是调查索拉非尼治疗的肝细胞癌（HCC）患者中脂肪量和骨骼肌量的快速消耗是否可预测死亡率。这项回顾性研究评估了61例HCC患者。通过计算机断层扫描测量内脏和皮下脂肪质量和骨骼肌质量的横截面积，由此获得内脏脂肪质量指数（VFMI）、皮下脂肪质量指数（SFMI）和骨骼肌指数（L3 SMI）。计算每例患者在索拉非尼治疗前后每120天这些指数的相对变化（Δ VFMI、Δ SFMI和Δ L3 SMI）。这些指标的第20百分位数临界值内的患者被归类为快速耗竭（RD）组。Kaplan-Meier分析显示，在Delta L3 SMI（p = 0.0101）和Delta SFMI（p = 0.0027）方面，RD组的生存率显著较差。使用考克斯比例风险模型进行的多变量分析也表明，Delta L3 SMI（-5.73;风险比[HR]：4.010，95%置信区间[CI]：1.799-8.938，p = < 0.001）和Delta SFMI（-5.33; HR：4.109，95%CI：1.967-8.584，p = < 0.001）是独立预测因子。引入索拉非尼后皮下脂肪量和骨骼肌量的快速消耗表明预后不良。
The aim of this study was to investigate whether rapid depletions of fat mass and skeletal muscle mass predict mortality in hepatocellular carcinoma (HCC) patients treated with sorafenib. This retrospective study evaluated 61 HCC patients. The cross-sectional areas of visceral and subcutaneous fat mass and skeletal muscle mass were measured by computed tomography, from which the visceral fat mass index (VFMI), subcutaneous fat mass index (SFMI), and skeletal muscle index (L3SMI) were obtained. The relative changes in these indices per 120 days (Delta VFMI, Delta SFMI, and Delta L3SMI) before and after sorafenib treatment were calculated in each patient. Patients within the 20th percentile cutoffs for these indices were classified into the rapid depletion (RD) group. Kaplan-Meier analysis revealed that with respect to Delta L3SMI (p = 0.0101) and Delta SFMI (p = 0.0027), the RD group had a significantly poorer survival. Multivariate analysis using the Cox proportional-hazards model also demonstrated that Delta L3SMI (-5.73; hazard ratio [HR]: 4.010, 95% confidence interval [CI]: 1.799-8.938, p = < 0.001) and Delta SFMI (-5.33; HR: 4.109, 95% CI: 1.967-8.584, p = < 0.001) were independent predictors. Rapid depletions of subcutaneous fat mass and skeletal muscle mass after the introduction of sorafenib indicate a poor prognosis.