Cachexia is an independent predictor of mortality in patients with hepatocellular carcinoma on systemic targeted therapy

IF 2.9 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-02-22 DOI:10.1016/j.clnesp.2025.02.018

Shinji Unome, Kenji Imai, Masashi Aiba, Takao Miwa, Tatsunori Hanai, Atsushi Suetsugu, Koji Takai, Masahito Shimizu

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引用次数: 0

Abstract

Background & aim

This study aimed to investigate the prevalence and prognostic impact of cachexia in patients with unresectable hepatocellular carcinoma (HCC) receiving systemic targeted therapy.

Methods

This single-center retrospective study included patients with HCC who underwent systemic targeted therapy. Cachexia was defined using novel criteria proposed in 2023. The prognostic impact of cachexia was evaluated using the Cox proportional hazards model.

Results

Of the 200 patients (160 males [80%]; median age, 73 years), cachexia was identified in 70 patients and associated with higher des-gamma-carboxy prothrombin levels, and extrahepatic spread. Patients with cachexia had significantly shorter overall survival (OS) (median 14.1 vs. 20.9 months, p = 0.002) and post-progression survival (PPS) (4.8 vs. 11.1 months, p = 0.001) compared to patients without cachexia. Multivariable analyses revealed cachexia as an independent adverse factor for OS (hazard ratio 1.54; 95% confidence interval 1.03–2.30, p = 0.035) and PPS (hazard ratio 1.64; 95% confidence interval 1.08–2.47, p = 0.018). No significant differences were observed in Progression-free survival between the two groups. Treatment discontinuation due to general appearance deterioration was more common in cachectic patients.

Conclusions

Cachexia was prevalent among patients with HCC receiving systemic targeted therapy and was identified as an independent predictor of poorer OS and PPS. Given the prognostic impact, the evaluation of cachexia is crucial in managing patients with HCC undergoing systemic targeted therapy.

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恶病质是接受系统性靶向治疗的肝癌患者死亡率的独立预测因子。

背景与目的：本研究旨在探讨不可切除肝细胞癌（HCC）患者接受全身靶向治疗时恶病质的患病率及其对预后的影响。方法：这项单中心回顾性研究纳入了接受全身靶向治疗的HCC患者。恶病质是根据2023年提出的新标准定义的。使用Cox比例风险模型评估恶病质的预后影响。结果：200例患者中，男性160例，占80%；中位年龄73岁)，70例患者发现恶病质，并伴有较高的去γ -羧基凝血酶原水平和肝外扩散。与没有恶病质的患者相比，恶病质患者的总生存期（OS）（中位14.1个月vs. 20.9个月，p = 0.002）和进展后生存期（PPS）（4.8个月vs. 11.1个月，p = 0.001）显著缩短。多变量分析显示恶病质是OS的独立不利因素(危险比1.54；95%置信区间1.03-2.30,p = 0.035)和PPS(风险比1.64；95%置信区间1.08-2.47,p = 0.018)。两组无进展生存期无显著差异。由于整体外观恶化而停止治疗在恶病质患者中更为常见。结论：恶病质在接受全身靶向治疗的HCC患者中普遍存在，并且被确定为较差的OS和PPS的独立预测因子。考虑到恶病质对预后的影响，评估恶病质对接受系统性靶向治疗的HCC患者的管理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.