Sarcopenia Predicts Reduced Survival in Patients with Hepatocellular Carcinoma at First Diagnosis
Ann. hepatol
;
16(1): 107-114, Jan.-Feb. 2017. graf
Artigo
em Inglês
| LILACS
| ID: biblio-838092
ABSTRACT
Abstract: Background. Sarcopenia is a complication and independent risk factor for mortality in patients with liver cirrhosis. Aim. To assess the prevalence and influence of sarcopenia on overall survival in a cohort of cirrhotic patients with hepatocellular carcinoma managed in a tertiary center. Material and methods. Abdominal computed tomography of 92 consecutive hepatocellular carcinoma cirrhotic patients, enrolled and followed from 2004 to 2014, were retrospectively studied with a software analyzing the cross-sectional areas of muscles at third lumbar vertebra level. Data was normalized for height, skeletal muscle index (SMI) calculated and presence of Sarcopenia measured. Sarcopenia was defined by SMI ≤ 41 cm2/m2 for women and ≤ 53 cm2/m2 for men with body mass index (BMI) ≥ 25, and ≤ 43 cm2/m2 for men and women with BMI < 25, respectively. Results. Median age at diagnosis was 71.9 years (30.7-86.4) and BMI 24.7 (17.5-36.7), comparable in women 23.1, (17.5-36.7) and men 24.7 (18.4-36.7). A class of CHILD score and BCLC A prevailed (55.4% and 41.3%, respectively); metastatic disease was found in 12% of cases. Sarcopenia was present in 40.2% of cases, mostly in females (62.9%; p = 0.005). Mean overall survival was reduced in sarcopenic patients, 66 (95% CI 47 to 84) vs. 123 (95% CI 98 to 150) weeks (p = 0.001). At multivariate analysis, sarcopenia was a predictor of reduced overall survival, independent of age (p = 0.0027). Conclusions. This retrospective study shows high prevalence of sarcopenia among cirrhotic patients with hepatocellular carcinoma. Presence of sarcopenia was identified as independent predictor of reduced overall survival. As easily measurable by CT, sarcopenia should be determined for prognostic purposes in this patient population.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Carcinoma Hepatocelular
/
Sarcopenia
/
Cirrose Hepática
/
Neoplasias Hepáticas
Tipo de estudo:
Estudo diagnóstico
/
Estudo de etiologia
/
Estudo observacional
/
Estudo de prevalência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Europa
Idioma:
Inglês
Revista:
Ann. hepatol
Assunto da revista:
Gastroenterologia
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Itália
Instituição/País de afiliação:
Sapienza University/IT
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