Abstract：
OBJECTIVE: Hepatocellular carcinoma (HCC) affects millions of people each year and is associated with high mortality and morbidity. Sarcopenia, a condition of muscle wasting, and decreased muscle performance is common among aging adults, and is associated with poor clinical outcomes. Individuals with HCC and chronic liver disease (CLD) are at high risk of sarcopenia because of the adverse effects of chronic inflammation, endocrine dysfunction, and hyperammonemia on muscle metabolism and adequate nutrition. Our aim is to review the clinical relationship between HCC and sarcopenia, and the assessment and management of these patients.
METHODS: A narrative review based on a literature search using PubMed. Keywords related to HCC and sarcopenia were used to identify relevant articles, primarily those published 2018-2023. The information was synthesized to provide a narrative review focused on the most recent literature.
UNASSIGNED: Sarcopenia frequently co-exists with HCC and increases risk for adverse clinical outcomes such as symptom burden, quality of life (QoL), survival, and side effects of antineoplastic therapy. Tools are available to screen, assess and manage patients with HCC, and although there is no specific pharmacologic agent approved for sarcopenia in the United States, multimodal therapy is feasible in daily practice. Comprehensive management by an interdisciplinary team should include nutritional counseling, an exercise regimen and control of symptoms affecting nutrition and function.
CONCLUSIONS: Sarcopenia has adverse effects on prognosis and tolerability of surgical and medical therapy in HCC. Patients with CLD and/or HCC would benefit from early identification, assessment, and therapeutic intervention. Management should be comprehensive, interdisciplinary, and include both pharmacologic and non-pharmacologic treatments. Further research is needed to identify individual agents that may mitigate muscle wasting and trials are needed to evaluate the benefit of multimodal therapy in HCC.
METHODS: A narrative review based on a literature search using PubMed. Keywords related to HCC and sarcopenia were used to identify relevant articles, primarily those published 2018-2023. The information was synthesized to provide a narrative review focused on the most recent literature.
UNASSIGNED: Sarcopenia frequently co-exists with HCC and increases risk for adverse clinical outcomes such as symptom burden, quality of life (QoL), survival, and side effects of antineoplastic therapy. Tools are available to screen, assess and manage patients with HCC, and although there is no specific pharmacologic agent approved for sarcopenia in the United States, multimodal therapy is feasible in daily practice. Comprehensive management by an interdisciplinary team should include nutritional counseling, an exercise regimen and control of symptoms affecting nutrition and function.
CONCLUSIONS: Sarcopenia has adverse effects on prognosis and tolerability of surgical and medical therapy in HCC. Patients with CLD and/or HCC would benefit from early identification, assessment, and therapeutic intervention. Management should be comprehensive, interdisciplinary, and include both pharmacologic and non-pharmacologic treatments. Further research is needed to identify individual agents that may mitigate muscle wasting and trials are needed to evaluate the benefit of multimodal therapy in HCC.
摘要：
目的：肝细胞癌（HCC）每年影响数百万人，并与高死亡率和发病率相关。肌肉减少症,肌肉萎缩的情况，肌肉性能下降在衰老的成年人中很常见，并且与不良的临床结果相关。由于慢性炎症的不利影响，患有HCC和慢性肝病（CLD）的人患有肌肉减少症的高风险，内分泌功能障碍,和高氨血症对肌肉代谢和充足营养的影响。我们的目的是回顾肝癌和肌少症之间的临床关系，以及这些患者的评估和管理。
方法：基于PubMed文献检索的叙述性综述。与HCC和肌少症相关的关键词用于鉴定相关文章，主要是2018-2023年出版的。综合了这些信息，以提供针对最新文献的叙述性评论。
■肌肉减少症经常与HCC共存，并增加不良临床结果的风险，如症状负担，生活质量（QoL），生存,和抗肿瘤治疗的副作用。工具可用于屏幕，评估和管理肝癌患者，尽管在美国没有批准治疗肌肉减少症的特定药物，多模式疗法在日常实践中是可行的。跨学科团队的全面管理应包括营养咨询，锻炼方案和控制影响营养和功能的症状。
结论：肌肉减少对HCC的预后和手术和药物治疗的耐受性有不利影响。CLD和/或HCC患者将受益于早期识别，评估，和治疗干预。管理要全面,跨学科,包括药物和非药物治疗。需要进一步的研究来确定可以减轻肌肉萎缩的个体药物，并且需要试验来评估多模式治疗在HCC中的益处。
方法：基于PubMed文献检索的叙述性综述。与HCC和肌少症相关的关键词用于鉴定相关文章，主要是2018-2023年出版的。综合了这些信息，以提供针对最新文献的叙述性评论。
■肌肉减少症经常与HCC共存，并增加不良临床结果的风险，如症状负担，生活质量（QoL），生存,和抗肿瘤治疗的副作用。工具可用于屏幕，评估和管理肝癌患者，尽管在美国没有批准治疗肌肉减少症的特定药物，多模式疗法在日常实践中是可行的。跨学科团队的全面管理应包括营养咨询，锻炼方案和控制影响营养和功能的症状。
结论：肌肉减少对HCC的预后和手术和药物治疗的耐受性有不利影响。CLD和/或HCC患者将受益于早期识别，评估，和治疗干预。管理要全面,跨学科,包括药物和非药物治疗。需要进一步的研究来确定可以减轻肌肉萎缩的个体药物，并且需要试验来评估多模式治疗在HCC中的益处。
