Dynamic Muscle Atrophy Predicts Outcomes in Patients with Unresectable Hepatocellular Carcinoma Treated with...

Area of Science:

• Hepatocellular Carcinoma Research
• Oncology
• Muscle Physiology

Background:

• Muscle volume loss (MVL) is linked to poor outcomes in hepatocellular carcinoma (HCC) patients.
• Dynamic muscle atrophy during HCC treatment is a critical, understudied concern.
• Lenvatinib is a first-line treatment for unresectable HCC.

Purpose of the Study:

• To evaluate the clinical significance of muscle volume loss (MVL).
• To assess the impact of severe muscle atrophy during lenvatinib treatment in unresectable HCC patients.
• To compare the prognostic value of MVL versus severe muscle atrophy.

Main Methods:

• Retrospective study of 302 unresectable HCC patients receiving first-line lenvatinib.
• Muscle volume loss (MVL) assessed via psoas muscle index.
• Severe muscle atrophy defined as ≥1.5% monthly decrease in psoas muscle index.
• Propensity score matching used to minimize selection bias.

Main Results:

• After matching, 168 patients showed MVL group had worse overall survival (9.9 vs 15.0 months) and higher adverse events (82.8% vs 66.6%).
• Severe muscle atrophy (n=76) was associated with significantly shorter progression-free survival (4.1 vs 10.9 months) and overall survival (11.1 vs 25.9 months).
• Multivariate analysis identified severe muscle atrophy as an independent risk factor for PFS and OS, while MVL was not.

Conclusions:

• Severe muscle atrophy is a more potent prognostic indicator than MVL in unresectable HCC patients on lenvatinib.
• Monitoring dynamic muscle changes is crucial for predicting treatment outcomes.
• This study provides real-world evidence for clinical practice in HCC management.