Abstract：
OBJECTIVE: Our purpose was to assess the impact of muscle quality on overall survival (OS) in patients with advanced HCC.
METHODS: This is a subanalysis of the SORAMIC trial. Overall, 363 patients were included. The SIRT/Sorafenib treatment group comprised 182 patients and the sorafenib group 181 patients. Myosteatosis was defined as skeletal muscle density (SMD) < 41 HU for patients with a body mass index up to 24.9 kg/m2 and <33 HU for patients with a body mass index ≥25 kg/m2. Albumin-gauge score was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on clinical variables and OS, a Cox regression model was used. Hazard ratios are presented together with 95 % confidence intervals (95 % CI). Kaplan-Meier curves were used for survival analysis.
RESULTS: In the SIRT/sorafenib cohort, low albumin-gauge score was an independent predictor of worse OS, HR = 1.74, CI 95% (1.16-2.62), p = 0.01. In the sorafenib cohort, muscle quality parameters did not predict OS. In alcohol-induced HCC (n = 129), myosteatosis independently predicted OS, HR = 1.85, CI 95% (1.10; 3.12), p = 0.02. In viral-induced HCC (n = 99), parameters of muscle quality did not predict OS. In patients with NASH/Non-alcoholic fatty liver disease (NAFLD) induced HCC, albumin-gauge score was a strong independent predictor of worse OS in the subgroup undergoing combined treatment with SIRT and sorafenib, HR = 9.86, CI 95% (1.12; 86.5), p = 0.04.
CONCLUSIONS: Myosteatosis predicts independently worse OS in patients with alcohol-induced HCC undergoing combined treatment with SIRT and sorafenib. In patients with NASH/NAFLD induced HCC undergoing treatment with SIRT and sorafenib, albumin-gauge score predicts independently worse OS.
UNASSIGNED: Associations between parameters of muscle quality and OS are different in accordance to the treatment strategy and etiology of HCC. These findings highlight the prognostic potential of skeletal muscle quality in patients with advanced HCC.
METHODS: This is a subanalysis of the SORAMIC trial. Overall, 363 patients were included. The SIRT/Sorafenib treatment group comprised 182 patients and the sorafenib group 181 patients. Myosteatosis was defined as skeletal muscle density (SMD) < 41 HU for patients with a body mass index up to 24.9 kg/m2 and <33 HU for patients with a body mass index ≥25 kg/m2. Albumin-gauge score was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on clinical variables and OS, a Cox regression model was used. Hazard ratios are presented together with 95 % confidence intervals (95 % CI). Kaplan-Meier curves were used for survival analysis.
RESULTS: In the SIRT/sorafenib cohort, low albumin-gauge score was an independent predictor of worse OS, HR = 1.74, CI 95% (1.16-2.62), p = 0.01. In the sorafenib cohort, muscle quality parameters did not predict OS. In alcohol-induced HCC (n = 129), myosteatosis independently predicted OS, HR = 1.85, CI 95% (1.10; 3.12), p = 0.02. In viral-induced HCC (n = 99), parameters of muscle quality did not predict OS. In patients with NASH/Non-alcoholic fatty liver disease (NAFLD) induced HCC, albumin-gauge score was a strong independent predictor of worse OS in the subgroup undergoing combined treatment with SIRT and sorafenib, HR = 9.86, CI 95% (1.12; 86.5), p = 0.04.
CONCLUSIONS: Myosteatosis predicts independently worse OS in patients with alcohol-induced HCC undergoing combined treatment with SIRT and sorafenib. In patients with NASH/NAFLD induced HCC undergoing treatment with SIRT and sorafenib, albumin-gauge score predicts independently worse OS.
UNASSIGNED: Associations between parameters of muscle quality and OS are different in accordance to the treatment strategy and etiology of HCC. These findings highlight the prognostic potential of skeletal muscle quality in patients with advanced HCC.
摘要：
目的：我们的目的是评估肌肉质量对晚期HCC患者总生存期（OS）的影响。
方法：这是SORAMIC试验的亚分析。总的来说,包括363例患者。SIRT/索拉非尼治疗组包括182名患者和索拉非尼组181名患者。肌萎缩症定义为体重指数为24.9kg/m2的患者骨骼肌密度（SMD）<41HU，体重指数≥25kg/m2的患者<33HU。白蛋白-标准评分计算如下:血清白蛋白(g/dL)×SMD(HU)。为了评估肌肉质量对临床变量和OS的影响，使用Cox回归模型。危险比与95%置信区间(95%CI)一起呈现。Kaplan-Meier曲线用于生存分析。
结果：在SIRT/索拉非尼队列中，低白蛋白量表评分是OS较差的独立预测因子，HR=1.74，CI95%（1.16-2.62），p=0.01。在索拉非尼队列中，肌肉质量参数不能预测OS。在酒精诱导的肝癌（n=129），肌肉骨化独立预测OS，HR=1.85，CI95%（1.10；3.12），p=0.02。在病毒诱导的肝癌（n=99），肌肉质量参数不能预测OS。在NASH/非酒精性脂肪性肝病（NAFLD）诱导的HCC患者中，在接受SIRT和索拉非尼联合治疗的亚组中，白蛋白-gauge评分是OS恶化的强独立预测因子，HR=9.86，CI95%（1.12；86.5），p=0.04。
结论：在接受SIRT和索拉非尼联合治疗的酒精诱导的HCC患者中，肌萎缩症独立预测OS恶化。在接受SIRT和索拉非尼治疗的NASH/NAFLD诱导的HCC患者中，白蛋白量表评分可独立预测操作系统恶化。
■肌肉质量参数和OS之间的关联根据HCC的治疗策略和病因而不同。这些发现突出了晚期HCC患者骨骼肌质量的预后潜力。
方法：这是SORAMIC试验的亚分析。总的来说,包括363例患者。SIRT/索拉非尼治疗组包括182名患者和索拉非尼组181名患者。肌萎缩症定义为体重指数为24.9kg/m2的患者骨骼肌密度（SMD）<41HU，体重指数≥25kg/m2的患者<33HU。白蛋白-标准评分计算如下:血清白蛋白(g/dL)×SMD(HU)。为了评估肌肉质量对临床变量和OS的影响，使用Cox回归模型。危险比与95%置信区间(95%CI)一起呈现。Kaplan-Meier曲线用于生存分析。
结果：在SIRT/索拉非尼队列中，低白蛋白量表评分是OS较差的独立预测因子，HR=1.74，CI95%（1.16-2.62），p=0.01。在索拉非尼队列中，肌肉质量参数不能预测OS。在酒精诱导的肝癌（n=129），肌肉骨化独立预测OS，HR=1.85，CI95%（1.10；3.12），p=0.02。在病毒诱导的肝癌（n=99），肌肉质量参数不能预测OS。在NASH/非酒精性脂肪性肝病（NAFLD）诱导的HCC患者中，在接受SIRT和索拉非尼联合治疗的亚组中，白蛋白-gauge评分是OS恶化的强独立预测因子，HR=9.86，CI95%（1.12；86.5），p=0.04。
结论：在接受SIRT和索拉非尼联合治疗的酒精诱导的HCC患者中，肌萎缩症独立预测OS恶化。在接受SIRT和索拉非尼治疗的NASH/NAFLD诱导的HCC患者中，白蛋白量表评分可独立预测操作系统恶化。
■肌肉质量参数和OS之间的关联根据HCC的治疗策略和病因而不同。这些发现突出了晚期HCC患者骨骼肌质量的预后潜力。
