The role of body composition parameters in sorafenib-treated hepatocellular carcinoma (HCC) patients is still not fully elucidated. Here, we aimed to evaluate the impact of computed tomography (CT)-based body composition parameters on the survival of such patients. In this multicenter study, we analyzed the data of 245 sorafenib-treated HCC patients from January 2008 to December 2019. Sarcopenia, visceral obesity, and myosteatosis were defined by using cross-sectional CT images at the third lumbar vertebra level. The effects of these parameters on overall survival (OS) and progression-free survival (PFS) were evaluated. The median age was 67.0 years (interquartile range: 61.0–78.0 year), and 211 patients (86.1%) were male. The median OS and PFS were 7.9 months and 4.8 months, respectively. Vascular invasion (hazard ratio (HR), 1.727; 95% confidence interval (CI), 1.258–2.371;p= 0.001), extrahepatic metastasis (HR, 1.401; 95% CI, 1.028–1.908;p= 0.033), alpha-fetoprotein level > 200 ng/mL (HR, 1.559; 95% CI, 1.105–2.201;p= 0.012), and myosteatosis (HR, 1.814; 95% CI, 1.112–2.960;p= 0.017) were associated with OS. Patient mortality was significantly higher in the group with two or more risk factors than in the group with fewer risk factors. In conclusion, myosteatosis may be a novel prognostic CT-based radiological biomarker in sorafenib-treated HCC patients.
身体成分参数在索拉非尼治疗的肝细胞癌患者中的作用尚未完全阐明。本研究旨在评估基于计算机断层扫描的身体成分参数对此类患者生存期的影响。在这项多中心研究中，我们分析了2008年1月至2019年12月期间245例接受索拉非尼治疗的肝细胞癌患者数据。通过第三腰椎水平的横断面CT图像定义肌肉减少症、内脏肥胖和肌脂肪变性，并评估这些参数对总生存期和无进展生存期的影响。患者中位年龄为67.0岁（四分位距：61.0-78.0岁），其中211例（86.1%）为男性。中位总生存期和无进展生存期分别为7.9个月和4.8个月。血管侵犯（风险比1.727，95%置信区间1.258-2.371，p=0.001）、肝外转移（风险比1.401，95%置信区间1.028-1.908，p=0.033）、甲胎蛋白水平>200 ng/mL（风险比1.559，95%置信区间1.105-2.201，p=0.012）以及肌脂肪变性（风险比1.814，95%置信区间1.112-2.960，p=0.017）与总生存期显著相关。具有两个及以上危险因素的患者死亡率显著高于危险因素较少的患者。综上所述，肌脂肪变性可能成为索拉非尼治疗的肝细胞癌患者中一种新型的基于CT影像的预后生物标志物。
肿瘤(癌症)患者之家