Sarcopenia Worsening One Month after Transarterial Radioembolization Predicts Progressive Disease in Patients with Advanced Hepatocellular Carcinoma

Vallati, Giulio; Trobiani, Claudio; Teodoli, Leonardo; Lai, Quirino; Cappelli, Federico; Ungania, Sara; Catalano, Carlo; Lucatelli, Pierleone

doi:10.3390/biology10080728

Cited by 10 publications

(21 citation statements)

References 21 publications

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“…A total of 57 studies involving 9790 HCC patients were included in the meta-analysis. The studies were conducted in different regions, with 41 studies 3 , 24 , 26 – 28 , 32 – 37 , 39 – 41 , 43 – 51 , 54 – 60 , 62 , 63 , 66 – 69 , 71 , 73 – 76 (Japan provided the largest volume of studies, followed by the South Korea) from Asia, and 16 studies 21 – 23 , 25 , 29 – 31 , 38 , 42 , 52 , 53 , 61 , 64 , 65 , 70 , 72 conducted in non-Asia regions. The enrolled patients covered all stages of HCC (from BCLC stage 0/A to BCLC stage D) and the corresponding treatments (RFA, hepatectomy, LDLT, TACE, TARE, radiotherapy, sorafenib, lenvatinib, and ICIs).…”

Section: Resultsmentioning

confidence: 99%

“…Notably, as the cut-off value increased, the prevalence of sarcopenia increased. The prevalence of sarcopenia ranged from 11.1% to 78.3% in 52 studies available 21 , 22 , 24 – 34 , 36 – 52 , 54 – 70 , 72 – 76 for the prevalence data, and the pooled prevalence was 41.7% (95% CI 36.2–47.2%) (Fig. S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Subgroup analyses of ORR and DCR were conducted on patients who received systemic therapy or TACE. The detailed data of ORR and DCR were available in four studies 22 , 40 , 68 , 76 on systemic therapy (two studies on lenvatinib, one study on sorafenib, and one study on gemcitabine and oxaliplatin) and two studies 49 , 72 on TACE. Results indicated that sarcopenia was associated with lower ORR and DCR in patients that received systemic therapy instead of TACE (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…Notably, as the cut-off value increased, the prevalence of sarcopenia increased. The prevalence of sarcopenia ranged from 11.1% to 78.3% in 52 studies available 21,22,[24][25][26][27][28][29][30][31][32][33][34][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][72][73][74][75]…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Association between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma: an updated meta-analysis

Guo

Ren

Zhu

et al. 2023

Sci Rep

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Although numerous studies have reported the association between sarcopenia and the prognosis of hepatocellular carcinoma (HCC) patients, there is lack of a newer and more comprehensive meta-analysis. Herein, a comprehensive literature search was performed on PubMed, Web of Science, the Cochrane Library, and Embase databases to identify relevant studies published up to February 2022. The outcomes were overall survival (OS), recurrence, progression‐free survival, tumor response, severe postoperative complications, and toxicity of drugs. A total of 57 studies involving 9790 HCC patients were included in the meta-analysis. The pooled prevalence of sarcopenia in HCC patients was 41.7% (95% CI 36.2–47.2%). Results demonstrated that sarcopenia was significantly associated with impaired OS (HR: 1.93, 95% CI 1.73–2.17, P < 0.001), higher risk of tumor recurrence (HR: 1.75, 95% CI 1.56–1.96, P < 0.001), lower objective response rate (OR: 0.37 95% CI 0.17–0.81, P = 0.012), and more drug-related adverse events (OR: 2.23, 95% CI 1.17–4.28, P = 0.015) in HCC patients. The subgroup analyses revealed that the OS of patients at the early stage of tumor was more severely affected by sarcopenia than for patients at other stages. Moreover, the presence of cirrhosis and Child Pugh class B increased the hazard of mortality from sarcopenia. This study has shown that sarcopenia is highly associated with poor prognosis in HCC patients. In addition, cirrhosis and poor liver functional reserve increase the danger of sarcopenia. OS was more impaired in HCC patients with sarcopenia at early stage of tumor than at other tumor stages.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Association between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma: an updated meta-analysis

Guo

Ren

Zhu

et al. 2023

Sci Rep

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“…In previous literatures, the efficacy of TKI therapy, liver transplantation, intra-arterial chemoembolization, and transarterial radioembolization has been linked to muscle status in patients with HCC. 13 , 14 , 23 , 27 – 29 A recent study suggested that sarcopenia may not be associated with an increased risk in patients with HCC receiving PD-1 inhibitors. 15 Given the small sample size of the mentioned study and the lack of a report on whether the baseline information of the two groups was balanced, further investigation is required to validate these findings.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of sarcopenia in patients with hepatocellular carcinoma treated with PD-1 inhibitor

Guo

Ren

et al. 2022

Therap Adv Gastroenterol

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Background: Sarcopenia is a progressive generalized loss of skeletal muscle mass commonly observed in advanced stages of cancer. Objective: To assess the relationship between sarcopenia and the prognosis of patients with hepatocellular carcinoma (HCC) treated with a programmed cell death 1 (PD-1) inhibitor. Design: This is a retrospective study. Methods: This study included patients with HCC treated with camrelizumab between 1 March 2020 and 1 December 2021. The skeletal muscle area at the L3 vertebra middle level was used to calculate the skeletal muscle index. Propensity score matching (PSM) analysis was used to balance the variables between the two groups. Results: In all, 97 patients with HCC were included in the study, with 46 and 51 patients in the sarcopenia group and the non-sarcopenia group, respectively. The baseline characteristics of albumin, Child-Pugh class, albumin–bilirubin score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were significantly different between the two groups. In total, 26 patients from each group ( n = 52) were selected after the PSM analysis. The progression-free survival (PFS) in the non-sarcopenia group was significantly longer than that in the sarcopenia group before and after PSM analysis (6.5 versus 4.8 months, p = 0.038). In addition, the disease control rate was similar before and after PSM analysis (57.7% versus 69.2%, p = 0.388). The objective response rate in the non-sarcopenia group tended to be higher than that in the sarcopenia group (11.5% versus 30.8%, p = 0.090, after PSM), but no statistically significant difference was found. The median overall survival (OS) in the non-sarcopenia group tended to longer than it in the sarcopenia group before PSM without significant differences (16.3 versus 11.3 months, p = 0.090) and the median OS was similar between the two groups after PSM (16.3 versus 16.8 months, p = 0.735). Conclusions: HCC patients with sarcopenia tended to have higher levels of inflammation and lower levels of albumin than patients without sarcopenia. Sarcopenia is associated with a shorter PFS in HCC patients treated with PD-1 inhibitor.

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Prognostic factors influencing outcomes in hepatocellular carcinoma patients undergoing selective internal radiation therapy

Franzè,

Vigneron,

Sessa

et al. 2024

Annals of Hepatology

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Sarcopenia Worsening One Month after Transarterial Radioembolization Predicts Progressive Disease in Patients with Advanced Hepatocellular Carcinoma

Cited by 10 publications

References 21 publications

Association between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma: an updated meta-analysis

Association between sarcopenia and clinical outcomes in patients with hepatocellular carcinoma: an updated meta-analysis

Prognostic impact of sarcopenia in patients with hepatocellular carcinoma treated with PD-1 inhibitor

Prognostic factors influencing outcomes in hepatocellular carcinoma patients undergoing selective internal radiation therapy

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