Abstract
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 (ΔVFMI, ΔSFMI, and ΔL3SMI) 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 ΔL3SMI (p = 0.0101) and ΔSFMI (p = 0.0027), the RD group had a significantly poorer survival. Multivariate analysis using the Cox proportional-hazards model also demonstrated that ΔL3SMI (≤−5.73 vs. >−5.73; hazard ratio [HR]: 4.010, 95% confidence interval [CI]: 1.799–8.938, p = < 0.001) and ΔSFMI (≤−5.33 vs. >−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.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide
High visceral fat mass (VFM) without skeletal muscle mass loss is associated with a better prognosis in HCC patients treated with sorafenib [20]
We examined the impact of the rapid depletion of skeletal muscle mass and fat mass on the survival of the HCC patients treated with sorafenib
Summary
Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. The prognosis of HCC is notably poor because only 46% of the patients are diagnosed at an early stage, and most do not receive curative therapy [2,3]. Even those who undergo curative therapy are usually prone to recurrence because HCC generally develops in patients with liver cirrhosis, which is regarded as a hyper-carcinogenic disease [4]. In addition to early detection and radical treatment for initial HCC, adequate therapy is critical to improve the prognosis of patients with this malignancy even when they are at an advanced stage
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