Haruki Uojima1,2, Makoto Chuma3, Yoshiaki Tanaka1, Hisashi Hidaka1, Takahide Nakazawa1,4, Shogo Iwabuchi5, Satoshi Kobayashi6, Nobuhiro Hattori7, Katsuaki Ogushi3, Manabu Morimoto6, Tatehiro Kagawa8, Katsuaki Tanaka9, Makoto Kako2, Wasaburo Koizumi1. 1. Department of Gastroenterology, Internal Medicine, Kitasato University School of Medicine, Sagamihara, Japan. 2. Department of Gastroenterology, Shonan Kamakura General Hospital, Kamakura, Japan. 3. Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan. 4. Nakazawa Medical Clinic, Sagamihara, Japan. 5. Department of Gastroenterology, Shonan Fujisawa Tokushukai Hospital, Fujisawa, Japan. 6. Department of Hepatobiliary and Pancreatic Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan. 7. Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan. 8. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan. 9. Department of Gastroenterology, Japanese Red Cross Hadano Hospital, Hadano, Japan.
Abstract
BACKGROUND: Low skeletal muscle mass is significantly associated with severe adverse events (AEs) from chemotherapy, and low tolerability leads to decreased survival. We aimed to investigate whether body skeletal muscle mass is correlated with tolerability and prognosis in patients with hepatocellular carcinoma (HCC) treated with lenvatinib. METHODS: This multicenter, retrospective study was conducted at five locations in Japan. We included 100 patients with HCC treated with lenvatinib. Skeletal muscle mass was measured by computed tomography and normalized for height in m<sup>2</sup> as skeletal muscle index (SMI). The assessment criteria for low SMI were taken from the sarcopenia criteria of the Japan Society of Hepatology. We investigated the influence of low SMI on drug withdrawal due to severe AEs in the first 2 months and on time to treatment failure (TTF) and overall survival (OS). RESULTS: The numbers of high- and low-SMI patients were 41 and 59, respectively. Those with severe AEs leading to withdraw in the high- and low-SMI groups were 7 and 23, respectively. The low-SMI group had a higher withdrawal rate than the high-SMI group (p = 0.042). The median TTF in the low- and high-SMI groups was 139 and 230 days, respectively. The median OS in the low- and high-SMI groups was 264 and 353 days, respectively. Patients in the low-SMI group experienced significantly worse OS and TTF than those in the high-SMI group (log-rank test for trend: TTF, p = 0.010; OS, p = 0.021). CONCLUSION: Decreased skeletal muscle mass is associated with the occurrence of severe AEs and worse TTF and OS. Skeletal muscle mass can be used as a predictive marker for tolerability and prognosis to lenvatinib in patients with HCC.
BACKGROUND: Low skeletal muscle mass is significantly associated with severe adverse events (AEs) from chemotherapy, and low tolerability leads to decreased survival. We aimed to investigate whether body skeletal muscle mass is correlated with tolerability and prognosis in patients with hepatocellular carcinoma (HCC) treated with lenvatinib. METHODS: This multicenter, retrospective study was conducted at five locations in Japan. We included 100 patients with HCC treated with lenvatinib. Skeletal muscle mass was measured by computed tomography and normalized for height in m<sup>2</sup> as skeletal muscle index (SMI). The assessment criteria for low SMI were taken from the sarcopenia criteria of the Japan Society of Hepatology. We investigated the influence of low SMI on drug withdrawal due to severe AEs in the first 2 months and on time to treatment failure (TTF) and overall survival (OS). RESULTS: The numbers of high- and low-SMI patients were 41 and 59, respectively. Those with severe AEs leading to withdraw in the high- and low-SMI groups were 7 and 23, respectively. The low-SMI group had a higher withdrawal rate than the high-SMI group (p = 0.042). The median TTF in the low- and high-SMI groups was 139 and 230 days, respectively. The median OS in the low- and high-SMI groups was 264 and 353 days, respectively. Patients in the low-SMI group experienced significantly worse OS and TTF than those in the high-SMI group (log-rank test for trend: TTF, p = 0.010; OS, p = 0.021). CONCLUSION: Decreased skeletal muscle mass is associated with the occurrence of severe AEs and worse TTF and OS. Skeletal muscle mass can be used as a predictive marker for tolerability and prognosis to lenvatinib in patients with HCC.
Authors: Carla M M Prado; Vickie E Baracos; Linda J McCargar; Tony Reiman; Marina Mourtzakis; Katia Tonkin; John R Mackey; Sheryl Koski; Edith Pituskin; Michael B Sawyer Journal: Clin Cancer Res Date: 2009-04-07 Impact factor: 12.531
Authors: W Kyle Mitchell; John Williams; Philip Atherton; Mike Larvin; John Lund; Marco Narici Journal: Front Physiol Date: 2012-07-11 Impact factor: 4.566