Sarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment. Issue 7 (August 2018)

• Record Type: Journal Article
• Authors: Antonelli, Giulio; Gigante, Elia; Iavarone, Massimo; Begini, Paola; Sangiovanni, Angelo; Iannicelli, Elsa; Biondetti, Piero; Pellicelli, Adriano M.; Miglioresi, Lucia; Marchetti, Paolo; Lampertico, Pietro; Marignani, Massimo
• Is Part Of: United European Gastroenterology journal. Volume 6:Issue 7(2018)
• Page Start: 1039
• Page End: 1048
• Publication Date: 2018-08
• Subjects: HCC -- skeletal muscle index -- CT scan -- prognostic factor -- performance status; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640618781188
• Languages: English
• ISSNs: 2050-6406

Abstract

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% 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.