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. 2018 Aug;6(7):1039-1048.
doi: 10.1177/2050640618781188. Epub 2018 May 31.

Sarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment

Giulio Antonelli  1 , Elia Gigante  1 , Massimo Iavarone  2 , Paola Begini  1 , Angelo Sangiovanni  2 , Elsa Iannicelli  3 , Piero Biondetti  4 , Adriano M Pellicelli  5 , Lucia Miglioresi  5 , Paolo Marchetti  6 , Pietro Lampertico  2 , Massimo Marignani  1
Affiliations

Sarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment

Giulio Antonelli et al. United European Gastroenterol J. 2018 Aug.

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.

Keywords: CT scan; HCC; performance status; prognostic factor; skeletal muscle index.

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Figures

Figure 1.
Figure 1.
Kaplan Meier Curve for Overall Survival comparing sarcopenic and non sarcopenic patients.
Figure 2.
Figure 2.
Kaplan Meier Curve for Sorafenib treatment duration comparing sarcopenic and non sarcopenic patients.
See this image and copyright information in PMC

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