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Skeletal muscle depletion is an independent prognostic factor for hepatocellular carcinoma.

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.

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  • Authors+Show Affiliations

    ,

    Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan.

    , , , , , , , ,

    Source

    Journal of gastroenterology 50:3 2015 Mar pg 323-32

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Biomarkers, Tumor
    Body Mass Index
    Carcinoma, Hepatocellular
    Female
    Humans
    Kaplan-Meier Estimate
    Liver Cirrhosis
    Liver Neoplasms
    Male
    Middle Aged
    Muscle, Skeletal
    Neoplasm Staging
    Prognosis
    Recurrence
    Retrospective Studies
    Risk Factors
    Sarcopenia
    Tomography, X-Ray Computed
    Treatment Outcome

    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 -