Effect of sarcopenia on systemic targeted therapy response in patients with advanced hepatocellular carcinoma.
Purpose: Sarcopenia is an independent prognostic indicator for hepatocellular carcinoma (HCC). Our objective was to determine the effect of sarcopenia on response to systemic targeted therapy in patients with advanced HCC. Materials and methods: This was a retrospective, Institutional Review Board a...
| Publicado en: | Abdominal Radiology Vol. 46; no. 3; pp. 1008 - 1016 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Mar2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149129793&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149129793 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 2366004X JT14 jtl: Abdominal Radiology issn: 2366004X maglogo: N pubinfo: dt: Mar2021 vid: 46 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 149129793 146050833 10.1007/s00261-020-02751-9 149129793 ppf: 1008 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Effect of sarcopenia on systemic targeted therapy response in patients with advanced hepatocellular carcinoma. aug: au: Qayyum, Aliya Bhosale, Priya Aslam, Rizwan Avritscher, Rony Ma, Jingfei Pagel, Mark D. Sun, Jia Mohamed, Yehia Rashid, Asif Beretta, Laura Kaseb, Ahmed O. affil: Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Unit 1473, 1515 Holcombe Blvd, 77030, Houston, TX, USA sug: ab: Purpose: Sarcopenia is an independent prognostic indicator for hepatocellular carcinoma (HCC). Our objective was to determine the effect of sarcopenia on response to systemic targeted therapy in patients with advanced HCC. Materials and methods: This was a retrospective, Institutional Review Board approved study of 36 patients on systemic targeted therapy with immune checkpoint blockade (n = 25) or tyrosine kinase inhibitor (n = 11) for biopsy-proven advanced HCC. Skeletal muscle index (SMI) was calculated from erector spinae muscle area (SMA) at the level of T12 on pretreatment CT: [SMI = SMA (cm2)/height (m2)]. SMI was compared to treatment response defined as overall survival ≥ 1 year (nonsurgical patients) or > 50% HCC necrosis (surgical patients). Receiver operating characteristic curve and area under the curve was used for analysis with p < 0.05 for statistical significance. Results: Median age of men and women was 66.5 years (range 32–83) and 70 years (range 54–78), respectively. Liver disease etiology was nonalcoholic steatohepatitis (n = 9), hepatitis C (n = 10), hepatitis B (n = 5), alcohol (n = 3) and unknown (n = 9). Mean (± SD) height and SMI for men were 1.7 m (± 0.1) and 11.4 (± 3.6); values for women were 1.7 m (± 0.1) and 8.2 (± 1.9). Treatment was withdrawn in five patients due to treatment intolerance. Response occurred in 10/31 (32.3%) patients (23 men, 8 women). T12SMI correlated with treatment response using a threshold of 7.21-8.23 for women (AUC = 1; p = 0.037), and 11.47 for men (AUC = 0.83; p = 0.015); correlation was increased for men ≥ 60 years, (AUC = 0.87; p = 0.023). Conclusion: Sarcopenia was associated with reduced survival and HCC necrosis in patients treated with systemic targeted therapy. Clinical relevance: Sarcopenia may help in predicting outcomes to targeted therapy in advanced HCC. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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