Correlation between sarcopenia and adipose tissue content assessed by quantitative CT and the prognosis of hepatocellular carcinoma patients receiving TACE combined with PD-1 monoclonal antibody
Correlation between sarcopenia and adipose tissue content assessed by quantitative CT and the prognosis of hepatocellular carcinoma patients receiving TACE combined with PD-1 monoclonal antibody
Objective:This study was to investigate the association of sarcopenia and adipose tis-sue content assessed by quantitative CT(QCT)with the prognosis of HCC patients treated with tran-scatheter arterial chemoembolization(TACE)combined with programmed death receptor 1(PD-1)monoclonal antibody.Methods:A retrospective analysis was performed on 77 patients with HCC who received TACE combined with PD-1 antibody from Jan 2019 to Jan 2022.All patients received QCT scan 1 month prior to first combination therapy.The skeletal muscle area,total adipose tissue area,subcutaneous adipose tissue area and visceral adipose tissue area were measured at the L3-level.The skeletal muscle index(SMI),total adipose tissue index(TATI),subcutaneous adipose tissue index(SATI),and visceral adipose tissue index(VATI)were calculated.The cut-off values of TATI,SATI and VATI were obtained by drawing the ROC curves.Assessment of sarcopenia by SMI.Results:ROC curve showed that the cut-off values of TATI,SATI and VATI were 61.75cm2/m2,30.52cm2/m2,61.52cm2/m2,respectively.The SMI was(48.03+7.34)cm2/m2 in men and(40.96+4.76)cm2/m2 in women.The overall incidence of sarcopenia was 51.9％(40/77).Multivariate analysis showed that sar-copenia,SATI,and tumor diameter were independent influencing factors for the progression-free sur-vival of HCC patients after TACE in combination with PD-1 monoclonal antibody(P＜0.05).It was subsequently verified in the follow-up of overall survival that patients without sarcopenia and high SA-TI survived significantly longer than those with sarcopenia and low SATI,with statistically significant differences(19.5 months vs.10.4 months;19.5 months vs.13.0 months,P＜0.05).Conclusion:Sar-copenia,SATI,and tumor diameter were independent prognostic factors for TACE in combination with PD-1 monoclonal antibody in patients with HCC.Sarcopenia and low subcutaneous adipose tissue content assessed based on QCT were associated with poor survival time in patients with HCC treated with TACE combined with PD-1 monoclonal antibody.
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