{"title":"Cachexia Index as a Prognostic Indicator in Patients with Unresectable Hepatocellular Carcinoma Receiving Atezolizumab and Bevacizumab Therapy.","authors":"Khanh Van Nguyen, Kosuke Matsui, Hisashi Kosaka, Hideyuki Matsushima, Hidekazu Yamamoto, Tung Thanh Lai, Kyoko Inoue, Moriyasu Takada, Fujimasa Tada, Atsushi Hiraoka, Takeshi Hatanaka, Toshifumi Tada, Takashi Kumada, Hiroki Kato, Kengo Yoshii, Takashi Yamaguchi, Shinji Shimoda, Makoto Naganuma, Masaki Kaibori","doi":"10.1159/000544979","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and aim: </strong>We investigated the association between the pretreatment cachexia index (CXI) and survival outcomes in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev).</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 195 patients with u-HCC treated with Atez/Bev from September 2020 to December 2023. The skeletal muscle mass index (SMI) was calculated by normalizing the psoas muscle area by the square of the height (cm²/m²). The CXI was defined as the SMI × serum albumin level (g/dL)/neutrophil-to-lymphocyte ratio. Propensity score matching (PSM) was applied to minimize the effect of potential confounders. Associations between CXI, overall survival (OS), and progression-free survival (PFS) were assessed.</p><p><strong>Results: </strong>From the initial cohort, CXI cutoffs of 7.23 for males and 4.99 for females were established. PSM matched 60 pairs of patients with low and high CXI, showing no significant differences in confounding factors between groups. Kaplan-Meier analysis indicated that the low-CXI group had shorter median OS (12.5 versus 26.1 months, p = 0.009) and PFS (6.1 versus 11.1 months, p = 0.045) compared with the high-CXI group. No significant differences existed between groups in overall response rate (p = 0.994) and disease control rate (p = 0.090). Multivariate Cox proportional hazards analysis identified low CXI as an independent prognostic factor for OS (HR: 1.89, 95% CI: 1.11-3.22, p = 0.019) and PFS (HR: 1.53, 95% CI: 1.01-2.34, p = 0.047).</p><p><strong>Conclusions: </strong>The CXI may be a valuable prognostic tool for predicting survival outcomes in patients with u-HCC receiving Atez/Bev.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-21"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000544979","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background and aim: We investigated the association between the pretreatment cachexia index (CXI) and survival outcomes in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev).
Methods: We conducted a retrospective analysis of 195 patients with u-HCC treated with Atez/Bev from September 2020 to December 2023. The skeletal muscle mass index (SMI) was calculated by normalizing the psoas muscle area by the square of the height (cm²/m²). The CXI was defined as the SMI × serum albumin level (g/dL)/neutrophil-to-lymphocyte ratio. Propensity score matching (PSM) was applied to minimize the effect of potential confounders. Associations between CXI, overall survival (OS), and progression-free survival (PFS) were assessed.
Results: From the initial cohort, CXI cutoffs of 7.23 for males and 4.99 for females were established. PSM matched 60 pairs of patients with low and high CXI, showing no significant differences in confounding factors between groups. Kaplan-Meier analysis indicated that the low-CXI group had shorter median OS (12.5 versus 26.1 months, p = 0.009) and PFS (6.1 versus 11.1 months, p = 0.045) compared with the high-CXI group. No significant differences existed between groups in overall response rate (p = 0.994) and disease control rate (p = 0.090). Multivariate Cox proportional hazards analysis identified low CXI as an independent prognostic factor for OS (HR: 1.89, 95% CI: 1.11-3.22, p = 0.019) and PFS (HR: 1.53, 95% CI: 1.01-2.34, p = 0.047).
Conclusions: The CXI may be a valuable prognostic tool for predicting survival outcomes in patients with u-HCC receiving Atez/Bev.
期刊介绍：
Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.
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