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Article

Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy

  • Authors:
    • Hiroki Nishikawa
    • Norihiro Nishijima
    • Hirayuki Enomoto
    • Azusa Sakamoto
    • Akihiro Nasu
    • Hideyuki Komekado
    • Takashi Nishimura
    • Ryuichi Kita
    • Toru Kimura
    • Hiroko Iijima
    • Shuhei Nishiguchi
    • Yukio Osaki
  • View Affiliations / Copyright

    Affiliations: Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663‑8501, Japan, Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka 543‑8555, Japan
  • Pages: 1637-1647
    |
    Published online on: May 31, 2017
       https://doi.org/10.3892/ol.2017.6287
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Abstract

The present study aimed to examine the impact of sarcopenia, defined as low muscle mass on computed tomography (CT), prior to sorafenib therapy on the clinical outcomes of patients with hepatocellular carcinoma (HCC) receiving sorafenib therapy. In total, 232 patients with unresectable HCC (median age, 72 years) were analyzed, and the extent of sarcopenia was assessed using CT. Cross‑sectional areas (cm2) of the skeletal muscles at the third lumbar vertebra level were determined by manual outlining on the CT images. The cross‑sectional areas were normalized for height [skeletal muscle index (SMI), cm2/m2]. Based on the findings of previous studies, male patients with SMI ≤36.2 cm2/m2 and female patients with SMI ≤29.6 cm2/m2 were defined as having sarcopenia. The baseline characteristics, overall survival (OS) rates, progression‑free survival (PFS) rates and best treatment response of the sarcopenia group were retrospectively compared with those of the non‑sarcopenia group, and the factors associated with OS and PFS were examined. Sarcopenia was observed in 151 patients (65.1%). There were 165 patients with Child‑Pugh A and 67 with Child‑Pugh B cirrhosis. In the sarcopenia group, the median treatment duration was 66 days, whereas in the non‑sarcopenia group it was 103 days (P=0.001). The median OS time was 174 days in the sarcopenia group and 454 days in the non‑sarcopenia group (P<0.0001). The median PFS was 77 days in the sarcopenia group and 106 days in the non‑sarcopenia group (P=0.0131). Multivariate analysis identified sarcopenia to be an independent predictor of OS (hazard ratio, 0.365; P<0.0001). The objective response rate and disease control rate in the sarcopenia group were significantly lower, compared with those in the non‑sarcopenia group (P=0.0146 and P=0.0151, respectively). In conclusion, sarcopenia may be an indicator of poor clinical course in patients with HCC receiving sorafenib.
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Copy and paste a formatted citation
Spandidos Publications style
Nishikawa H, Nishijima N, Enomoto H, Sakamoto A, Nasu A, Komekado H, Nishimura T, Kita R, Kimura T, Iijima H, Iijima H, et al: Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy. Oncol Lett 14: 1637-1647, 2017.
APA
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H. ... Osaki, Y. (2017). Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy. Oncology Letters, 14, 1637-1647. https://doi.org/10.3892/ol.2017.6287
MLA
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H., Nishimura, T., Kita, R., Kimura, T., Iijima, H., Nishiguchi, S., Osaki, Y."Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy". Oncology Letters 14.2 (2017): 1637-1647.
Chicago
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H., Nishimura, T., Kita, R., Kimura, T., Iijima, H., Nishiguchi, S., Osaki, Y."Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy". Oncology Letters 14, no. 2 (2017): 1637-1647. https://doi.org/10.3892/ol.2017.6287
Copy and paste a formatted citation
x
Spandidos Publications style
Nishikawa H, Nishijima N, Enomoto H, Sakamoto A, Nasu A, Komekado H, Nishimura T, Kita R, Kimura T, Iijima H, Iijima H, et al: Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy. Oncol Lett 14: 1637-1647, 2017.
APA
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H. ... Osaki, Y. (2017). Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy. Oncology Letters, 14, 1637-1647. https://doi.org/10.3892/ol.2017.6287
MLA
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H., Nishimura, T., Kita, R., Kimura, T., Iijima, H., Nishiguchi, S., Osaki, Y."Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy". Oncology Letters 14.2 (2017): 1637-1647.
Chicago
Nishikawa, H., Nishijima, N., Enomoto, H., Sakamoto, A., Nasu, A., Komekado, H., Nishimura, T., Kita, R., Kimura, T., Iijima, H., Nishiguchi, S., Osaki, Y."Prognostic significance of sarcopenia in patients with hepatocellular carcinoma undergoing sorafenib therapy". Oncology Letters 14, no. 2 (2017): 1637-1647. https://doi.org/10.3892/ol.2017.6287
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