Clinical importance of muscle volume in lenvatinib treatment for hepatocellular carcinoma: Analysis adjusted with inverse probability weighting.


Journal

Journal of gastroenterology and hepatology
ISSN: 1440-1746
Titre abrégé: J Gastroenterol Hepatol
Pays: Australia
ID NLM: 8607909

Informations de publication

Date de publication:
Jul 2021
Historique:
revised: 19 09 2020
received: 17 07 2020
accepted: 04 11 2020
pubmed: 11 11 2020
medline: 15 12 2021
entrez: 10 11 2020
Statut: ppublish

Résumé

This study aimed to elucidate the clinical importance of muscle volume loss (pre-sarcopenia) in patients receiving lenvatinib as treatment for unresectable hepatocellular carcinoma (u-HCC). Of 437 u-HCC patients treated with lenvatinib at specific institutions in Japan between March 2018 and May 2020, 151 with available computed tomography imaging data from the time of lenvatinib introduction were enrolled. Pre-sarcopenia was diagnosed based on a previously reported cut-off value calculation formula [psoas muscle area at level of middle of third lumbar vertebra (cm Cox hazard multivariate analysis showed alpha-fetoprotein (≥400 ng/mL) (hazard ratio [HR] 2.271, P < 0.001), Barcelona Clinic Liver Cancer stage (C and D) (HR 1.625, P = 0.018), and positive for pre-sarcopenia (HR 1.652, P = 0.042) to be significant prognostic factors. OS rates for the pre-sarcopenia group (n = 41) were worse than those for the non-pre-sarcopenia group (n = 110) (0.5-, 1-, and 1.5-year OS: 72.5%, 27.9%, and 7.0% vs 80.7%, 56.7%, and 46.1%, respectively; P < 0.001), as was progression-free survival (P = 0.025). Time to stopping lenvatinib or disease progression was better in the non-pre-sarcopenia group (0.5-, 1-, and 1.5-year OS: 48.0%, 24.5%, and 8.4% vs 20.0%, 10.3%, and 4.2%, respectively; P < 0.001). Also, the frequency of the adverse event appetite loss (any grade) was greater in the pre-sarcopenia group (43.9% vs 18.2%, P = 0.003). Pre-sarcopenia was shown to be a significant prognostic factor in patients treated with lenvatinib for u-HCC.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
This study aimed to elucidate the clinical importance of muscle volume loss (pre-sarcopenia) in patients receiving lenvatinib as treatment for unresectable hepatocellular carcinoma (u-HCC).
METHODS METHODS
Of 437 u-HCC patients treated with lenvatinib at specific institutions in Japan between March 2018 and May 2020, 151 with available computed tomography imaging data from the time of lenvatinib introduction were enrolled. Pre-sarcopenia was diagnosed based on a previously reported cut-off value calculation formula [psoas muscle area at level of middle of third lumbar vertebra (cm
RESULTS RESULTS
Cox hazard multivariate analysis showed alpha-fetoprotein (≥400 ng/mL) (hazard ratio [HR] 2.271, P < 0.001), Barcelona Clinic Liver Cancer stage (C and D) (HR 1.625, P = 0.018), and positive for pre-sarcopenia (HR 1.652, P = 0.042) to be significant prognostic factors. OS rates for the pre-sarcopenia group (n = 41) were worse than those for the non-pre-sarcopenia group (n = 110) (0.5-, 1-, and 1.5-year OS: 72.5%, 27.9%, and 7.0% vs 80.7%, 56.7%, and 46.1%, respectively; P < 0.001), as was progression-free survival (P = 0.025). Time to stopping lenvatinib or disease progression was better in the non-pre-sarcopenia group (0.5-, 1-, and 1.5-year OS: 48.0%, 24.5%, and 8.4% vs 20.0%, 10.3%, and 4.2%, respectively; P < 0.001). Also, the frequency of the adverse event appetite loss (any grade) was greater in the pre-sarcopenia group (43.9% vs 18.2%, P = 0.003).
CONCLUSION CONCLUSIONS
Pre-sarcopenia was shown to be a significant prognostic factor in patients treated with lenvatinib for u-HCC.

Identifiants

pubmed: 33171524
doi: 10.1111/jgh.15336
pmc: PMC8359359
doi:

Substances chimiques

Antineoplastic Agents 0
Phenylurea Compounds 0
Quinolines 0
lenvatinib EE083865G2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1812-1819

Informations de copyright

© 2020 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

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Auteurs

Atsushi Hiraoka (A)

Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.

Takashi Kumada (T)

Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan.

Kazuya Kariyama (K)

Department of Gastroenterology, Okayama City Hospital, Okayama, Japan.

Toshifumi Tada (T)

Department of Internal Medicine, Himeji Red Cross Hospital, Himeji, Japan.

Joji Tani (J)

Department of Gastroenterology and Hepatology, Kagawa University, Takamatsu, Japan.

Shinya Fukunishi (S)

Department of Gastroenterology, Osaka Medical College, Osaka, Japan.

Masanori Atsukawa (M)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

Masashi Hirooka (M)

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.

Kunihiko Tsuji (K)

Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.

Toru Ishikawa (T)

Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.

Koichi Takaguchi (K)

Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.

Ei Itobayashi (E)

Department of Gastroenterology, Asahi General Hospital, Asahi, Japan.

Kazuto Tajiri (K)

Department of Gastroenterology, Toyama University Hospital, Toyama, Japan.

Noritomo Shimada (N)

Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan.

Hiroshi Shibata (H)

Department of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan.

Hironori Ochi (H)

Hepato-biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.

Kazuhito Kawata (K)

Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

Satoshi Yasuda (S)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan.

Hidenori Toyoda (H)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Gifu, Japan.

Hideko Ohama (H)

Department of Gastroenterology, Osaka Medical College, Osaka, Japan.

Kazuhiro Nouso (K)

Department of Gastroenterology, Okayama City Hospital, Okayama, Japan.

Akemi Tsutsui (A)

Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.

Takuya Nagano (T)

Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan.

Norio Itokawa (N)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

Korenobu Hayama (K)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

Taeang Arai (T)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

Michitaka Imai (M)

Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan.

Yohei Koizumi (Y)

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.

Shinichiro Nakamura (S)

Department of Internal Medicine, Himeji Red Cross Hospital, Himeji, Japan.

Kouji Joko (K)

Hepato-biliary Center, Matsuyama Red Cross Hospital, Matsuyama, Japan.

Kojiro Michitaka (K)

Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.

Yoichi Hiasa (Y)

Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan.

Masatoshi Kudo (M)

Department of Gastroenterology, Kindai University, Osaka, Japan.

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