Albumin-muscle density score predicts overall survival in patients with hepatocellular cancer undergoing treatment with transarterial chemoembolization
Year: 2024
Type: article
Study design: Observational Study
Abstract: PURPOSE: The purpose of the present study was to analyze associations between different skeletal muscle quality parameters and survival in patients with hepatocellular carcinoma (HCC) undergoing treatment with transarterial chemoembolization (TACE). METHODS: We retrospectively enrolled 784 treatment-naïve patients with HCC undergoing TACE at six tertiary care centers between 2010 and 2020. Intramuscular adipose tissue (IMAT) and skeletal muscle density (SMD) were estimated. Myosteatosis was defined as SMD < 28.0 HU for men and < 23.8 HU for women. Furthermore, albumin-SMD score (ADS) was calculated as follows: serum albumin (g/dL) × SMD (HU). To assess the impact of muscle quality on survival, Cox regression model was used. Kaplan-Meier curves were used for survival analysis. Parameters of skeletal muscle quality were compared in univariate and multivariate regression analyses, adjusted for established risk factors. RESULTS: In the overall sample, survivors had higher SMD and ADS in comparison to non-survivors. Patients with low ADS had a lower OS than patients with high ADS (8.4 vs. 14.3 months, p < 0.001). In alcohol-induced HCC, none of the analyzed parameters of muscle quality influenced survival. In viral induced HCC, patients with low ADS had lower OS than patients with high ADS (8.8 vs. 15.7 months, p < 0.001). In patients with non-alcoholic steatohepatitis (NASH), none of the analyzed parameters of muscle quality influenced survival. CONCLUSIONS: Low ADS is an independent predictor of worse OS in patients with viral-induced HCC undergoing treatment with TACE. In alcohol-induced and NASH-induced HCCs, parameters of muscle quality do not influence OS.
Authors: Alexey Surov, Andreas Wienke, Jan Borggrefe, Timo Alexander Auer, Bernhard Gebauer, Aline Mähringer-Kunz, Felix Nensa, Johannes Haubold, Benedikt Michael Schaarschmidt, René Hosch, Jens Kleesiek, Thierno D. Diallo, Natascha Roehlen, Dominik Bettinger, Michel Eisenblätter, Verena Steinle, Philipp Mayer, David Zopfs, Daniel Pinto dos Santos, Lukas Müller, Roman Kloeckner
Institutions: Johannes Wesling Klinikum Minden, Ruhr University Bochum, Charité - Universitätsmedizin Berlin, Martin Luther University Halle-Wittenberg, Johannes Gutenberg University Mainz, University Medical Center of the Johannes Gutenberg University Mainz, Essen University Hospital, University Medical Center Freiburg, Bielefeld University, Heidelberg University, University Hospital Heidelberg, University Hospital Cologne, University of Lübeck
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,190
OpenAlex ID: W4404874739
