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Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis.
Ann Hepatol 2017 Jan-Feb 2017; 16(1):107-114AH

Abstract

Background.

Sarcopenia is a complication and independent risk factor for mortality in patients with liver cirrhosis.

AIM

To assess the prevalence and influence of sarcopenia on overall survival in a cohort of cirrhotic patients with hepatocellular carcinoma managed in a tertiary center.

MATERIAL AND METHODS

Abdominal computed tomography of 92 consecutive hepatocellular carcinoma cirrhotic patients, enrolled and followed from 2004 to 2014, were retrospectively studied with a software analyzing the cross-sectional areas of muscles at third lumbar vertebra level. Data was normalized for height, skeletal muscle index (SMI) calculated and presence of Sarcopenia measured. Sarcopenia was defined by SMI ≤ 41 cm2/m2 for women and ≤ 53 cm2/m2 for men with body mass index (BMI) ≥ 25, and ≤ 43 cm2/m2 for men and women with BMI < 25, respectively.

RESULTS

Median age at diagnosis was 71.9 years (30.7-86.4) and BMI 24.7 (17.5-36.7), comparable in women 23.1, (17.5-36.7) and men 24.7 (18.4-36.7). A class of CHILD score and BCLC A prevailed (55.4% and 41.3%, respectively); metastatic disease was found in 12% of cases. Sarcopenia was present in 40.2% of cases, mostly in females (62.9%; p = 0.005). Mean overall survival was reduced in sarcopenic patients, 66 (95% CI 47 to 84) vs. 123 (95% CI 98 to 150) weeks (p = 0.001). At multivariate analysis, sarcopenia was a predictor of reduced overall survival, independent of age (p = 0.0027).

CONCLUSIONS

This retrospective study shows high prevalence of sarcopenia among cirrhotic patients with hepatocellular carcinoma. Presence of sarcopenia was identified as independent predictor of reduced overall survival. As easily measurable by CT, sarcopenia should be determined for prognostic purposes in this patient population.

Authors+Show Affiliations

Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Radiology Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Radiology Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Liver Unit, San Camillo Forlanini Hospital, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.Digestive and Liver Diseases Department, Sant'Andrea Hospital, School of Medicine and Psychology, Sapienza University, Rome, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28051799

Citation

Begini, Paola, et al. "Sarcopenia Predicts Reduced Survival in Patients With Hepatocellular Carcinoma at First Diagnosis." Annals of Hepatology, vol. 16, no. 1, 2017, pp. 107-114.
Begini P, Gigante E, Antonelli G, et al. Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis. Ann Hepatol. 2017;16(1):107-114.
Begini, P., Gigante, E., Antonelli, G., Carbonetti, F., Iannicelli, E., Anania, G., ... Marignani, M. (2017). Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis. Annals of Hepatology, 16(1), pp. 107-114. doi:10.5604/16652681.1226821.
Begini P, et al. Sarcopenia Predicts Reduced Survival in Patients With Hepatocellular Carcinoma at First Diagnosis. Ann Hepatol. 2017;16(1):107-114. PubMed PMID: 28051799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sarcopenia predicts reduced survival in patients with hepatocellular carcinoma at first diagnosis. AU - Begini,Paola, AU - Gigante,Elia, AU - Antonelli,Giulio, AU - Carbonetti,Francesco, AU - Iannicelli,Elsa, AU - Anania,Giulia, AU - Imperatrice,Barbara, AU - Pellicelli,Adriano Maria, AU - Fave,Gianfranco Delle, AU - Marignani,Massimo, PY - 2017/1/5/entrez PY - 2017/1/5/pubmed PY - 2017/3/1/medline SP - 107 EP - 114 JF - Annals of hepatology JO - Ann Hepatol VL - 16 IS - 1 N2 - : Background. Sarcopenia is a complication and independent risk factor for mortality in patients with liver cirrhosis. AIM: To assess the prevalence and influence of sarcopenia on overall survival in a cohort of cirrhotic patients with hepatocellular carcinoma managed in a tertiary center. MATERIAL AND METHODS: Abdominal computed tomography of 92 consecutive hepatocellular carcinoma cirrhotic patients, enrolled and followed from 2004 to 2014, were retrospectively studied with a software analyzing the cross-sectional areas of muscles at third lumbar vertebra level. Data was normalized for height, skeletal muscle index (SMI) calculated and presence of Sarcopenia measured. Sarcopenia was defined by SMI ≤ 41 cm2/m2 for women and ≤ 53 cm2/m2 for men with body mass index (BMI) ≥ 25, and ≤ 43 cm2/m2 for men and women with BMI < 25, respectively. RESULTS: Median age at diagnosis was 71.9 years (30.7-86.4) and BMI 24.7 (17.5-36.7), comparable in women 23.1, (17.5-36.7) and men 24.7 (18.4-36.7). A class of CHILD score and BCLC A prevailed (55.4% and 41.3%, respectively); metastatic disease was found in 12% of cases. Sarcopenia was present in 40.2% of cases, mostly in females (62.9%; p = 0.005). Mean overall survival was reduced in sarcopenic patients, 66 (95% CI 47 to 84) vs. 123 (95% CI 98 to 150) weeks (p = 0.001). At multivariate analysis, sarcopenia was a predictor of reduced overall survival, independent of age (p = 0.0027). CONCLUSIONS: This retrospective study shows high prevalence of sarcopenia among cirrhotic patients with hepatocellular carcinoma. Presence of sarcopenia was identified as independent predictor of reduced overall survival. As easily measurable by CT, sarcopenia should be determined for prognostic purposes in this patient population. SN - 1665-2681 UR - https://www.unboundmedicine.com/medline/citation/28051799/ Sarcopenia_predicts_reduced_survival_in_patients_with_hepatocellular_carcinoma_at_first_diagnosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/1226821 DB - PRIME DP - Unbound Medicine ER -