骨骼肌质量可以预测用SIRT和Sorafenib治疗的晚期肝肝癌癌的总体生存：Soramic试验的亚分析
Skeletal muscle quality predicts overall survival in advanced liver hepatocellular carcinoma treated with SIRT and sorafenib: A subanalysis of the SORAMIC trial
影响因子:6.70000
分区:医学2区 / 胃肠肝病学3区
发表日期:2024 Oct
作者:
Alexey Surov, Andreas Wienke, Jan Borggrefe, Mattes Hinnerichs, Ricarda Seidensticker, Osman Öcal, Kerstin Schütte, Christoph J Zech, Christian Loewe, Otto van Delden, Vincent Vandecaveye, Chris Verslype, Bernhard Gebauer, Christian Sengel, Irene Bargellini, Roberto Iezzi, Peter Malfertheiner, Thomas Berg, Heinz J Klümpen, Julia Benckert, Antonio Gasbarrini, Holger Amthauer, Bruno Sangro, Jens Ricke, Max Seidensticker
摘要
我们的目的是评估肌肉质量对晚期HCC患者总生存期（OS）的影响。这是对soramic试验的亚分析。总体而言，包括363名患者。 SIRT/SORFENIB治疗组包括182例患者和索拉非尼组181例患者。对于体重指数≥25kg/m2的患者的体重指数高达24.9 kg/m2的患者的骨骼肌密度（SMD）<41 HU的骨骼肌密度（SMD）<41 HU。白蛋白 - 柱得分的计算如下：血清白蛋白（G/DL）×SMD（HU）。为了评估肌肉质量对临床变量和OS的影响，使用了COX回归模型。危险比与95％的置信区间（95％CI）一起呈现。 Kaplan-Meier曲线用于生存分析。在SIRT/SORFENIB队列中，低白蛋白 - 算法得分是OS较差的独立预测指标，HR = 1.74，CI 95％（1.16-2.62），p = 0.01。在索拉非尼队列中，肌肉质量参数无法预测OS。在酒精诱导的HCC（n = 129）中，Myosteatosis独立预测OS，HR = 1.85，CI 95％（1.10; 3.12），p = 0.02。在病毒诱导的HCC（n = 99）中，肌肉质量的参数无法预测OS。 In patients with NASH/Non-alcoholic fatty liver disease (NAFLD) induced HCC, albumin-gauge score was a strong independent predictor of worse OS in the subgroup undergoing combined treatment with SIRT and sorafenib, HR = 9.86, CI 95% (1.12; 86.5), p = 0.04.Myosteatosis predicts independently worse OS in patients with alcohol-induced HCC undergoing combined treatment with SIRT and索拉非尼。在接受SIRT和索拉非尼治疗的NASH/NAFLD诱导的HCC患者中，白蛋白 - 规分数预测独立的OS。肌肉质量和OS参数之间的共同体因HCC的治疗策略和病因而不同。这些发现突出了晚期HCC患者骨骼肌质量的预后潜力。
Abstract
Our purpose was to assess the impact of muscle quality on overall survival (OS) in patients with advanced HCC.This is a subanalysis of the SORAMIC trial. Overall, 363 patients were included. The SIRT/Sorafenib treatment group comprised 182 patients and the sorafenib group 181 patients. Myosteatosis was defined as skeletal muscle density (SMD) < 41 HU for patients with a body mass index up to 24.9 kg/m2 and <33 HU for patients with a body mass index ≥25 kg/m2. Albumin-gauge score was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on clinical variables and OS, a Cox regression model was used. Hazard ratios are presented together with 95 % confidence intervals (95 % CI). Kaplan-Meier curves were used for survival analysis.In the SIRT/sorafenib cohort, low albumin-gauge score was an independent predictor of worse OS, HR = 1.74, CI 95% (1.16-2.62), p = 0.01. In the sorafenib cohort, muscle quality parameters did not predict OS. In alcohol-induced HCC (n = 129), myosteatosis independently predicted OS, HR = 1.85, CI 95% (1.10; 3.12), p = 0.02. In viral-induced HCC (n = 99), parameters of muscle quality did not predict OS. In patients with NASH/Non-alcoholic fatty liver disease (NAFLD) induced HCC, albumin-gauge score was a strong independent predictor of worse OS in the subgroup undergoing combined treatment with SIRT and sorafenib, HR = 9.86, CI 95% (1.12; 86.5), p = 0.04.Myosteatosis predicts independently worse OS in patients with alcohol-induced HCC undergoing combined treatment with SIRT and sorafenib. In patients with NASH/NAFLD induced HCC undergoing treatment with SIRT and sorafenib, albumin-gauge score predicts independently worse OS.Associations between parameters of muscle quality and OS are different in accordance to the treatment strategy and etiology of HCC. These findings highlight the prognostic potential of skeletal muscle quality in patients with advanced HCC.