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Published on: September 12, 2019
Progressive sarcopenia and myosteatosis predict prognosis of advanced HCC patients treated with immune checkpoint
Mengchen Liu1, Qianna Jin2,3, Huiyan Wang1
1Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Progressive sarcopenia and myosteatosis predict worse outcomes in advanced liver cancer patients on immunotherapy. High visceral fat also correlates with reduced survival, highlighting body composition
Area of Science:
- Hepatobiliary Medicine
- Medical Oncology
- Radiology
Background:
- Advanced hepatocellular carcinoma (HCC) treatment relies on immunotherapy, but patient responses vary.
- Sarcopenia, myosteatosis, and adiposity indicators may influence immunotherapy effectiveness in HCC.
- Investigating changes in these indicators during treatment could reveal prognostic factors.
Purpose of the Study:
- To assess the impact of sarcopenia, myosteatosis, and adiposity on treatment response and prognosis in advanced HCC patients receiving immune checkpoint inhibitors.
- To analyze how changes in these body composition metrics during treatment affect clinical outcomes.
- To identify potential imaging biomarkers for predicting immunotherapy response in HCC.
Main Methods:
- Retrospective analysis of 116 advanced HCC patients treated with immune checkpoint inhibitors.
- Computed tomography scans at the L3 vertebrae assessed skeletal muscle and adipose tissue before and after 3 months of treatment.
- Sarcopenia and myosteatosis evaluated using skeletal muscle index and mean muscle density; outcomes analyzed via log-rank test and Cox regression.
Main Results:
- Progressive sarcopenia and myosteatosis were associated with objective response rates (P=0.021, P=0.001).
- Progressive myosteatosis predicted disease control rates (P<0.001).
- Progressive sarcopenia and myosteatosis independently predicted progression-free survival (P=0.002, P=0.018); progressive sarcopenia, performance status, and visceral adipose tissue predicted overall survival (P=0.005, P=0.006, P=0.001).
Conclusions:
- Progressive sarcopenia and myosteatosis are significant predictors of poor clinical outcomes in advanced HCC patients undergoing immunotherapy.
- High baseline visceral adiposity is linked to diminished survival in this patient group.
- Body composition changes during treatment offer valuable prognostic information for HCC immunotherapy.
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