Skeletal muscle depletion predicts the prognosis of patients with hepatocellular carcinoma treated with sorafenib.
The aim of this study was to determine whether skeletal muscle depletion predicts the prognosis of patients with hepatocellular carcinoma (HCC) that is being treated with sorafenib. We evaluated 40 consecutive HCC patients who received sorafenib treatment. The skeletal muscle cross-sectional area was measured by computed tomography at the third lumbar vertebra (L3), from which the L3 skeletal muscle index (L3 SMI) was obtained. The factors contributing to overall survival, sorafenib dose reduction, and discontinuation of sorafenib were analyzed using the Cox proportional hazards model. L3 SMI (p = 0.020) and log (α-fetoprotein (AFP)) (p = 0.010) were identified as independent prognostic factors in HCC patients treated with sorafenib. The initial dose of sorafenib (p = 0.008) was an independent risk factor for sorafenib dose reduction, and log (AFP) (p = 0.008) was the only significant risk factor for the discontinuation of this drug. L3 SMI was not a risk factor for either dose reduction (p = 0.423) or the discontinuation (p = 0.132) of sorafenib. A multiple linear regression analysis determined the following relationship between skeletal muscle mass (assessed as L3 SMI) and the explanatory factors: L3 SMI = -0.1896 × (Age) - 10.3441 × (Child-Pugh score) - 9.3922 × (log (AFP)) + 1.6139 × (log (AFP)) × (Child-Pugh score) + 112.9166. Skeletal muscle depletion is inversely associated with age, Child-Pugh score, and log (AFP). Moreover, it is an independent prognostic factor for HCC patients treated with sorafenib.
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. ikenji@gifu-u.ac.jp.
Kenji
K
Imai
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. koz@gifu-u.ac.jp.
Koji
K
Takai
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. hanai0606@yahoo.co.jp.
Tatsunori
T
Hanai
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. taka.mailbox.789@gmail.com.
Takayasu
T
Ideta
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. tsunemiyazaking@yahoo.co.jp.
Tsuneyuki
T
Miyazaki
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. kottii924@gmail.com.
Takahiro
T
Kochi
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. asue327@yahoo.co.jp.
Atsushi
A
Suetsugu
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. mshiraki-gif@umin.ac.jp.
Makoto
M
Shiraki
Department of Gastroenterology/Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu 501-1194, Japan. mshiraki-gif@umin.ac.jp.
Masahito
M
Shimizu
D000368:Aged; D000375:Aging / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy*; D003710:Demography; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D015999:Multivariate Analysis; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology*; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000009:adverse effects* / Q000627:therapeutic use*; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D000077157:Sorafenib; D028761:Withholding Treatment
D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib