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Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma.
J Gastroenterol 2015; 50(3):323-32JG

Abstract

BACKGROUND

Skeletal muscle depletion or sarcopenia has been identified as a poor prognostic factor for various diseases. The aim of this study is to determine whether muscle depletion is a prognostic factor for hepatocellular carcinoma (HCC).

METHODS

We evaluated 217 consecutive patients with primary HCC. The skeletal muscle cross-sectional area was measured by computed tomography at the third lumbar vertebra (L3), from which the total body fat-free mass (FFM) and L3 skeletal muscle index (L3 SMI) were obtained. The factors contributing to overall survival (OS) were analyzed by univariate and multivariate Cox proportional hazards model.

RESULTS

In univariate analysis, FFM (P = 0.0422), Child-Pugh classification (P = 0.0058), serum albumin level (P < 0.0001), serum AFP level (P < 0.0001), serum proteins induced by vitamin K absence or antagonist-II level (P < 0.0001), cancer stage (P < 0.0001), and curability of the initial treatment (P < 0.0001) were significantly associated with the prognosis of HCC. Multivariate analysis indicated that FFM (P = 0.0499), albumin level (P = 0.0398), and curability of the initial treatment (P = 0.0008) were independent prognostic factors. Sarcopenia was defined as an L3 SMI value of ≤29.0 cm(2)/m(2) for women and ≤36.0 cm(2)/m(2) for men, and 24 patients (11.1%) have sarcopenia. Sarcopenic patients showed a significantly lower OS than those without sarcopenia (P = 0.0043). Sarcopenic patients who were overweight (BMI >22) died earlier (P = 0.0129).

CONCLUSIONS

Skeletal muscle depletion is an independent prognostic factor. Intervention to prevent muscle wasting might be an effective strategy for improving the outcome of HCC.

Authors+Show Affiliations

Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24817668

Citation

Iritani, Soichi, et al. "Skeletal Muscle Depletion Is an Independent Prognostic Factor for Hepatocellular Carcinoma." Journal of Gastroenterology, vol. 50, no. 3, 2015, pp. 323-32.
Iritani S, Imai K, Takai K, et al. Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. J Gastroenterol. 2015;50(3):323-32.
Iritani, S., Imai, K., Takai, K., Hanai, T., Ideta, T., Miyazaki, T., ... Moriwaki, H. (2015). Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. Journal of Gastroenterology, 50(3), pp. 323-32. doi:10.1007/s00535-014-0964-9.
Iritani S, et al. Skeletal Muscle Depletion Is an Independent Prognostic Factor for Hepatocellular Carcinoma. J Gastroenterol. 2015;50(3):323-32. PubMed PMID: 24817668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma. AU - Iritani,Soichi, AU - Imai,Kenji, AU - Takai,Koji, AU - Hanai,Tatsunori, AU - Ideta,Takayasu, AU - Miyazaki,Tsuneyuki, AU - Suetsugu,Atsushi, AU - Shiraki,Makoto, AU - Shimizu,Masahito, AU - Moriwaki,Hisataka, Y1 - 2014/05/10/ PY - 2013/12/27/received PY - 2014/04/20/accepted PY - 2014/5/13/entrez PY - 2014/5/13/pubmed PY - 2015/11/18/medline SP - 323 EP - 32 JF - Journal of gastroenterology JO - J. Gastroenterol. VL - 50 IS - 3 N2 - BACKGROUND: Skeletal muscle depletion or sarcopenia has been identified as a poor prognostic factor for various diseases. The aim of this study is to determine whether muscle depletion is a prognostic factor for hepatocellular carcinoma (HCC). METHODS: We evaluated 217 consecutive patients with primary HCC. The skeletal muscle cross-sectional area was measured by computed tomography at the third lumbar vertebra (L3), from which the total body fat-free mass (FFM) and L3 skeletal muscle index (L3 SMI) were obtained. The factors contributing to overall survival (OS) were analyzed by univariate and multivariate Cox proportional hazards model. RESULTS: In univariate analysis, FFM (P = 0.0422), Child-Pugh classification (P = 0.0058), serum albumin level (P < 0.0001), serum AFP level (P < 0.0001), serum proteins induced by vitamin K absence or antagonist-II level (P < 0.0001), cancer stage (P < 0.0001), and curability of the initial treatment (P < 0.0001) were significantly associated with the prognosis of HCC. Multivariate analysis indicated that FFM (P = 0.0499), albumin level (P = 0.0398), and curability of the initial treatment (P = 0.0008) were independent prognostic factors. Sarcopenia was defined as an L3 SMI value of ≤29.0 cm(2)/m(2) for women and ≤36.0 cm(2)/m(2) for men, and 24 patients (11.1%) have sarcopenia. Sarcopenic patients showed a significantly lower OS than those without sarcopenia (P = 0.0043). Sarcopenic patients who were overweight (BMI >22) died earlier (P = 0.0129). CONCLUSIONS: Skeletal muscle depletion is an independent prognostic factor. Intervention to prevent muscle wasting might be an effective strategy for improving the outcome of HCC. SN - 1435-5922 UR - https://www.unboundmedicine.com/medline/citation/24817668/Skeletal_muscle_depletion_is_an_independent_prognostic_factor_for_hepatocellular_carcinoma_ L2 - https://dx.doi.org/10.1007/s00535-014-0964-9 DB - PRIME DP - Unbound Medicine ER -