Objective: To investigated the association between sarcopenia and the prognosis and adverse events of hepatocellular carcinoma (HCC) patients undergoing interventional therapy combined with immunotherapy and targeted therapy.
Methods: Between January 2019 and December 2022, patients with unresectable HCC who received interventional therapy combined with immunotherapy and targeted therapy were included in this study. Total skeletal muscle area at the L3 level was normalized for height in m² as the skeletal muscle index (SMI). All patients were divided into low and high SMI group according to the median SMI.
Results: Ninety-six consecutive patients were included eventually, with 49 patients in the high-SMI group and 47 patients in the low-SMI group. In the low-SMI group, the median overall survival (OS) was 459.00 days (95% CI, 334.76– 583.24 days), and the 3-, 6-, and 12-month OS rates were 100%, 89.4% and 68.1%, respectively. In the high-SMI group, the median OS was not reached, and the 3-, 6-, and 12-month OS rates were 100%, 98% and 79.5%, respectively (p< 0.05). SMI and Barcelona Clinic Liver Cancer (BCLC) C stage were independent prognostic factors for OS (p< 0.05). In the low-SMI group, 26 patients had treatment-related adverse events (TRAEs), resulting in dose adjustment or treatment suspension for 10 patients. In the high-SMI group, 33 patients had TRAEs, and 18 patients received dose adjustment or treatment suspension; the between-group difference was nonsignificant (p> 0.05).
Conclusion: SMI is associated with the prognosis of HCC patients receiving interventional therapy combined with immunotherapy and targeted therapy, and sarcopenia is an independent risk factor for OS. However, sarcopenia does not seem to predict the occurrence of adverse events.

Keywords: hepatocellular carcinoma, sarcopenia, immune checkpoint inhibitors, tyrosine kinase inhibitors, transarterial chemoembolization


中文翻译：

---

介入治疗联合免疫治疗和靶向治疗对肝细胞癌肌少症患者预后的影响

目的：探讨肌少症与接受介入治疗联合免疫治疗和靶向治疗的肝细胞癌（HCC）患者的预后和不良事件的关系。
方法： 2019年1月至2022年12月期间接受介入治疗联合免疫治疗和靶向治疗的不可切除的HCC患者纳入本研究。L3 水平的总骨骼肌面积针对高度（以 m ²为单位）进行标准化，作为骨骼肌指数 (SMI)。根据中位SMI将所有患者分为低SMI组和高SMI组。
结果：最终连续纳入96例患者，其中高SMI组49例，低SMI组47例。在低SMI组中，中位总生存期（OS）为459.00天（95% CI，334.76-583.24天），3个月、6个月和12个月OS率分别为100%、89.4%和68.1 ％， 分别。在高 SMI 组中，未达到中位 OS，3、6 和 12 个月 OS 率分别为 100%、98% 和 79.5%（p < 0.05）。SMI 和巴塞罗那临床肝癌 (BCLC) C 期是 OS 的独立预后因素 ( p < 0.05)。在低SMI组中，26名患者出现治疗相关不良事件（TRAE），导致10名患者调整剂量或暂停治疗。高SMI组中，33例患者出现TRAE，18例患者接受剂量调整或暂停治疗；组间差异不显着（p > 0.05）。
结论： SMI与接受介入治疗联合免疫治疗和靶向治疗的HCC患者的预后相关，肌少症是OS的独立危险因素。然而，肌肉减少症似乎并不能预测不良事件的发生。

关键词:肝细胞癌, 肌肉减少症, 免疫检查点抑制剂, 酪氨酸激酶抑制剂, 经动脉化疗栓塞