文章：

低骨骼肌质量对经动脉放射栓塞治疗肝细胞癌患者长期预后的影响：一项回顾性多中心研究

Impact of Low Skeletal Muscle Mass on Long-Term Outcomes in Hepatocellular Carcinoma Treated with Trans-Arterial Radioembolization: A Retrospective Multi-Center Study

原文发布日期：28 October 2023

DOI: 10.3390/cancers15215195

类型: Article

开放获取: 是

英文摘要：

Trans-arterial radioembolization (TARE) is a form of radiation therapy performed for hepatocellular carcinoma (HCC) via selective intra-arterial injection of Yttrium-90-loaded microspheres. This was a multi-center retrospective study of consecutive patients with HCC who underwent TARE between July 2009 and May 2019. Using pre-treatment computed tomography imaging, the total cross-sectional area (cm2) of the abdominal skeletal muscle at the third lumbar vertebra was measured. The skeletal muscle index (SMI) was calculated by normalizing the muscle area to patient height. In total, 347 patients (median age, 65 years; 284 male) were included in the study. A total of 108 (31.1%) patients had portal vein tumor thrombus (PVTT), and 126 (36.3%) were classified as LSMM. The median overall survival (OS) was 28.1 months (95% CI, 24.8–35.7), and median progression-free survival was 8.0 months (95% CI, 6.4–9.4). Multivariate Cox regression analysis revealed that LSMM (hazard ratio [HR], 1.36; 95% CI, 1.00–1.85,p= 0.05), PVTT (HR, 1.82; 95% CI, 1.33–2.49,p< 0.01), alpha-fetoprotein (AFP) (≥200 ng/mL) (HR 1.41; 95% CI, 1.04–1.92,p= 0.03), and albumin–bilirubin grade (2–3) (HR 1.74; 95% CI, 1.24–2.43,p< 0.01) were independently associated with poor OS. TARE provided favorable long-term outcomes for patients with advanced HCC. Pre-treatment LSMM independently associated with survival, suggesting its utility as a surrogate biomarker for identifying TARE candidates.

摘要翻译： 

经动脉放射栓塞术（TARE）是一种通过选择性动脉内注射钇-90微球对肝细胞癌（HCC）实施的放射治疗方式。本研究为一项多中心回顾性研究，纳入2009年7月至2019年5月期间连续接受TARE治疗的HCC患者。通过治疗前计算机断层扫描影像，测量第三腰椎水平腹部骨骼肌的总横截面积（cm²）。骨骼肌指数（SMI）通过将肌肉面积按患者身高标准化计算得出。研究共纳入347例患者（中位年龄65岁；男性284例），其中108例（31.1%）存在门静脉癌栓（PVTT），126例（36.3%）被归类为低骨骼肌质量（LSMM）。患者中位总生存期（OS）为28.1个月（95% CI，24.8–35.7），中位无进展生存期为8.0个月（95% CI，6.4–9.4）。多变量Cox回归分析显示，LSMM（风险比[HR]，1.36；95% CI，1.00–1.85，p=0.05）、PVTT（HR，1.82；95% CI，1.33–2.49，p<0.01）、甲胎蛋白（AFP）（≥200 ng/mL）（HR 1.41；95% CI，1.04–1.92，p=0.03）以及白蛋白-胆红素分级（2–3级）（HR 1.74；95% CI，1.24–2.43，p<0.01）均与不良OS独立相关。TARE为晚期HCC患者提供了良好的长期预后。治疗前LSMM与生存期独立相关，提示其可作为筛选TARE候选者的替代生物标志物。

原文链接：

Impact of Low Skeletal Muscle Mass on Long-Term Outcomes in Hepatocellular Carcinoma Treated with Trans-Arterial Radioembolization: A Retrospective Multi-Center Study