Abstract
Objective:hepatocellular carcinoma (HCC) is a dreadful complication of liver cirrhosis. Aim was to study the effect of sarcopenia on the survival in patients with HCC. Methods:we included 262 patients and were followed up for 12 months. Sarcopenia was calculated by skeletal muscle index (SMI). Sarcopenia was defined by SMI ≤39 cm2/m2 for women and ≤50 cm2/m2 for men. Results:patients with sarcopenia (n= 113, 43.1%) were older, mainly males, Child-Pugh class B and smokers. Patients with sarcopenia had lower survival than those without (10.09 vs. 11.72 months). Survival was also lower in Barcelona clinic liver cancer stage C than B and A (9.02 vs. 11.21 vs. 11.89 months). Age and sarcopenia were hazardous of mortality (p<0.05). There was statistically significant difference of serial SMI in patients without baseline sarcopenia unlike patients with baseline sarcopenia. On follow up patients with sarcopenia had higher incidence of ascites (45% vs. 20.4%), spontaneous bacterial peritonitis (21.7% vs. 11.6%), hepatic encephalopathy (28% vs. 11.5%) and bleeding (22.9% vs. 12.7%). Totally patients with sarcopenia had higher incidence of progressive HCC (39% vs. 25.5%). Conclusion:Sarcopenia is associated with lack of response to therapy, liver decompensation and higher mortality in hepatocellular carcinoma patients.
Highlights
Hepatocellular carcinoma (HCC) is a dreadful complication of the liver cirrhosis that is associated with short survival
Sarcopenia is associated with lack of response to therapy, liver decompensation and higher mortality in hepatocellular carcinoma patients
hepatocellular carcinoma (HCC) is an ominous complication of liver cirrhosis
Summary
Hepatocellular carcinoma (HCC) is a dreadful complication of the liver cirrhosis that is associated with short survival. The generalized loss of both the function and the mass of muscles, is called sarcopenia. Sarcopenia may be due to aging or secondary to medical disease like liver cirrhosis (Bunchorntavakul and Reddy, 2020). There are multiple factors that cause malnutrition and subsequent sarcopenia in patients with cirrhosis. Decreased nutrient intake is common owing to anorexia, protein restriction, disturbed conscious state and taste change. The energy metabolism is altered due to hypercatabolic state and altered metabolism for carbohydrates, proteins, and fat. Another factor is repeated fasting with bleeding, encephalopathy and before procedures (Dasarathy and Merli, 2016; Bunchorntavakul and Reddy, 2020)
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