Open AccessSarcopenia is associated with reduced survival in patients with advanced hepatocellular carcinoma undergoing sorafenib treatment
Author(s) -
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
Publication year - 2018
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640618781188
Subject(s) - sarcopenia , medicine , sorafenib , hepatocellular carcinoma , gastroenterology , confidence interval , cirrhosis , retrospective cohort study , multivariate analysis , surgery
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.