Sarcopenia with muscle wasting in hepatic cancer predicts therapeutic outcome after hepatic artery intervention.

Objectives: We aimed to study sarcopenia for its significance in predicting the effect of hepatic artery intervention (HAI) plus lenvatinib on hepatitis B-related hepatocellular carcinoma (HCC) complicated with diabetes mellitus (DM).

Materials and methods: Hepatitis B-related HCC patients complicated with DM (n = 102) visiting during January 2021 and December 2023 were retrospectively selected. Computed tomography was performed to detect the third lumbar vertebra for its muscle cross-sectional area. A non-sarcopenia group (59 cases) plus a sarcopenia group (43 cases, men with a skeletal muscle index ≤ 40.8 cm²/m² and women with a skeletal muscle index ≤ 34.9 cm²/m²) were established according to different skeletal muscle indexes.

Results: Significant decline in body mass index (BMI) and albumin (ALB) level was observed in the sarcopenia group compared to the non-sarcopenia group (p < 0.05). The sarcopenia group, compared with the non-sarcopenia group, exhibited a significantly reduced objective response rate (53.49 vs. 74.58%) (p < 0.05), while no significant intergroup difference was discovered in the disease control rate (95.35 vs. 91.53%) (p < 0.05). Low BMI, alpha fetoprotein (AFP), low ALB, and pre-chemotherapy sarcopenia all influenced the overall clinical efficacy, as independent influencing factors (p < 0.05).

Conclusion: Sarcopenia may attenuate the efficacy of HAI plus lenvatinib on hepatitis B-related HCC with DM, and BMI, AFP and ALB are factors affecting the therapeutic effect.