Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles
Introduction: Sarcopenia is an adverse prognostic factor in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Image-based sarcopenia assessment allows a standardized method to assess abdominal skeletal muscle. However, which is an index muscle for sarcopenia remains unclear. Therefor...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-02-01
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| Series: | Liver Cancer |
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| Online Access: | https://www.karger.com/Article/FullText/529676 |
| _version_ | 1827981692754722816 |
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| author | Chih-Horng Wu Ming-Chih Ho Chien-Hung Chen Ja-Der Liang Kai-Wen Huang Mei-Fang Cheng Chih-Kai Chang Chia-Hung Chang Po-Chin Liang |
| author_facet | Chih-Horng Wu Ming-Chih Ho Chien-Hung Chen Ja-Der Liang Kai-Wen Huang Mei-Fang Cheng Chih-Kai Chang Chia-Hung Chang Po-Chin Liang |
| author_sort | Chih-Horng Wu |
| collection | DOAJ |
| description | Introduction: Sarcopenia is an adverse prognostic factor in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Image-based sarcopenia assessment allows a standardized method to assess abdominal skeletal muscle. However, which is an index muscle for sarcopenia remains unclear. Therefore, we investigated whether sarcopenia defined according to different muscle groups with computed tomography (CT) scans can predict the prognosis of HCC after radioembolization. Methods: In this retrospective study, we analyzed patients who underwent radioembolization for unresectable HCC between January 2010 and December 2019. Before treatment, the total abdominal muscle (TAM), psoas muscle (PM), and paraspinal muscle (PS) areas were evaluated using a single CT slice at the third lumbar vertebra. In previous studies, sarcopenia was determined using the TAM, PM, and PS after stratifying by sex. Finally, we investigated each muscle-defined sarcopenia to decide whether or not it can serve as a prognostic factor for overall survival (OS). Results: We included 92 patients (74 men and 18 women). TAM, PM, and PS areas were significantly higher in the men than in the women (all p < 0.05). The patients with sarcopenia defined using PM, but not TAM and PS, exhibited significantly poorer OS than those without sarcopenia (median 15.3 vs. 23.8 months, p = 0.034, 0.821, and 0.341, respectively). After adjustment for clinical variables, such as body mass index, liver function, alpha-fetoprotein level, clinical staging, treatment response, and posttreatment curative therapy, PM-defined sarcopenia (hazard ratio: 1.899, 95% confidence interval: 1.087–3.315) remained an independent predictor for the poor OS. Conclusion: CT-assessed sarcopenia defined using PM was an independent prognostic factor for the poorer prognosis of unresectable HCC after radioembolization. |
| first_indexed | 2024-04-09T22:13:03Z |
| format | Article |
| id | doaj.art-a4916fc8fb5442b7b5ca5fbc3a20dc34 |
| institution | Directory Open Access Journal |
| issn | 2235-1795 1664-5553 |
| language | English |
| last_indexed | 2024-04-09T22:13:03Z |
| publishDate | 2023-02-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Liver Cancer |
| spelling | doaj.art-a4916fc8fb5442b7b5ca5fbc3a20dc342023-03-23T06:54:58ZengKarger PublishersLiver Cancer2235-17951664-55532023-02-011110.1159/000529676529676Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal MusclesChih-Horng Wu0https://orcid.org/0000-0002-7498-4183Ming-Chih Ho1https://orcid.org/0000-0003-3660-1062Chien-Hung Chen2https://orcid.org/0000-0003-4979-3761Ja-Der Liang3https://orcid.org/0000-0002-4532-0118Kai-Wen Huang4https://orcid.org/0000-0001-6375-8714Mei-Fang Cheng5https://orcid.org/0000-0002-9359-0606Chih-Kai Chang6Chia-Hung Chang7https://orcid.org/0000-0002-9777-1957Po-Chin Liang8Departments of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanDepartments of Surgery, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartments of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartments of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, TaiwanDepartment of Surgery and Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, TaiwanDepartments of Nuclear Medicine and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanDepartments of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanDepartments of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanDepartments of Medical Imaging and Radiology, National Taiwan University Hospital and College of Medicine, Taipei, TaiwanIntroduction: Sarcopenia is an adverse prognostic factor in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Image-based sarcopenia assessment allows a standardized method to assess abdominal skeletal muscle. However, which is an index muscle for sarcopenia remains unclear. Therefore, we investigated whether sarcopenia defined according to different muscle groups with computed tomography (CT) scans can predict the prognosis of HCC after radioembolization. Methods: In this retrospective study, we analyzed patients who underwent radioembolization for unresectable HCC between January 2010 and December 2019. Before treatment, the total abdominal muscle (TAM), psoas muscle (PM), and paraspinal muscle (PS) areas were evaluated using a single CT slice at the third lumbar vertebra. In previous studies, sarcopenia was determined using the TAM, PM, and PS after stratifying by sex. Finally, we investigated each muscle-defined sarcopenia to decide whether or not it can serve as a prognostic factor for overall survival (OS). Results: We included 92 patients (74 men and 18 women). TAM, PM, and PS areas were significantly higher in the men than in the women (all p < 0.05). The patients with sarcopenia defined using PM, but not TAM and PS, exhibited significantly poorer OS than those without sarcopenia (median 15.3 vs. 23.8 months, p = 0.034, 0.821, and 0.341, respectively). After adjustment for clinical variables, such as body mass index, liver function, alpha-fetoprotein level, clinical staging, treatment response, and posttreatment curative therapy, PM-defined sarcopenia (hazard ratio: 1.899, 95% confidence interval: 1.087–3.315) remained an independent predictor for the poor OS. Conclusion: CT-assessed sarcopenia defined using PM was an independent prognostic factor for the poorer prognosis of unresectable HCC after radioembolization.https://www.karger.com/Article/FullText/529676computed tomographysarcopeniacarcinomahepatocellularprognosisradioembolization |
| spellingShingle | Chih-Horng Wu Ming-Chih Ho Chien-Hung Chen Ja-Der Liang Kai-Wen Huang Mei-Fang Cheng Chih-Kai Chang Chia-Hung Chang Po-Chin Liang Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles Liver Cancer computed tomography sarcopenia carcinoma hepatocellular prognosis radioembolization |
| title | Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles |
| title_full | Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles |
| title_fullStr | Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles |
| title_full_unstemmed | Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles |
| title_short | Computed Tomography-Defined Sarcopenia in Outcomes of Patients with Unresectable Hepatocellular Carcinoma Undergoing Radioembolization: Assessment with Total Abdominal, Psoas, and Paraspinal Muscles |
| title_sort | computed tomography defined sarcopenia in outcomes of patients with unresectable hepatocellular carcinoma undergoing radioembolization assessment with total abdominal psoas and paraspinal muscles |
| topic | computed tomography sarcopenia carcinoma hepatocellular prognosis radioembolization |
| url | https://www.karger.com/Article/FullText/529676 |
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