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Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study
Yoshihiko Yano
Corresponding Author
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This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Gastroenterology.
Background: A large-scale Japanese study showed that low skeletal muscle index (SMI) and intramuscular fat (IMF) deposition are associated with hepatocellular carcinoma (HCC) survival. Here, we evaluated the effects of SMI and IMF on the survival of Indonesian HCC patients, whose characteristics differ from those of Japanese patients.
Methods: SMI and mean muscle attenuation (MA) were evaluated using computed tomography images of the third lumbar vertebra (L3) in a prospective cohort of 100 Indonesian HCC patients. Clinical, laboratory and body composition data were analysed using the Kaplan–Meier method and Cox regression model to investigate which factors are associated with prognosis.
Results: Of 100 patients, 31 were diagnosed with sarcopenia (L3 SMI value ≤36.2 cm 2 /m 2 for men and ≤29.6 cm 2 /m 2 for women), and 65 had IMF deposition (MA value ≤44.4 HU for men and ≤39.3 HU for women). These groups had shorter median survival than the reference groups (both P <0.0001). In multivariable analysis, sarcopenia (hazard ratio [HR], 1.921; P = 0.016), IMF deposition (HR, 3.580; P <0.001), Barcelona Clinic Liver Cancer (BCLC) stages C and D (HR: 2.396, P <0.01 and HR: 6.131, P <0.01, respectively), Japan Integrated Staging (JIS) score 4 (HR: 2.067, P = 0.020), and male gender (HR: 3.211, P <0.001) were independently associated with mortality.
Conclusion: Sarcopenia and IMF deposition showed superior value in combination with BCLC stage and JIS score for predicting the survival of Indonesian HCC patients. Increased awareness and strategies to prevent or reverse these factors might improve patient outcomes.
Keywords
Sarcopenia, IMF deposition, hepatocellular carcinoma, prognosis, Indonesia
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CURRENT STATUS: Published
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Posted 23 Dec, 2019
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On 30 Dec, 2019
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On 20 Dec, 2019
Editorial decision: Accept
On 18 Dec, 2019
No comments provided
Submission checks complete
On 15 Dec, 2019
Editorial decision: Minor revision
On 13 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 09 Dec, 2019
Review #2 received
Received 07 Dec, 2019
Reviewer #2 agreed
On 28 Nov, 2019
Reviewer #1 agreed
On 26 Nov, 2019
Review #1 received
Received 26 Nov, 2019
Reviewers invited
Invitations sent on 25 Nov, 2019
Editor assigned
On 15 Nov, 2019
Submission checks complete
On 14 Nov, 2019
Editor invited
On 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 27 Oct, 2019
Reviewer #2 agreed
On 24 Oct, 2019
Review #1 received
Received 24 Oct, 2019
Reviewer #3 agreed
On 24 Oct, 2019
Review #2 received
Received 24 Oct, 2019
Reviewer #1 agreed
On 21 Oct, 2019
Reviewers invited
Invitations sent on 13 Oct, 2019
Submission checks complete
On 01 Oct, 2019
Editor assigned
On 27 Sep, 2019
Editor invited
On 26 Sep, 2019
First submitted
On 25 Sep, 2019
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Subject Areas
Gastroenterology & Hepatology
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This preprint is under consideration at BMC Gastroenterology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Sarcopenia and intramuscular fat deposition are associated with poor survival in Indonesian patients with hepatocellular carcinoma: a retrospective study
Yoshihiko Yano
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 23 Dec, 2019
Published
On 30 Dec, 2019
No community comments so far
Submission checks complete
On 20 Dec, 2019
Editorial decision: Accept
On 18 Dec, 2019
No comments provided
Submission checks complete
On 15 Dec, 2019
Editorial decision: Minor revision
On 13 Dec, 2019
No comments provided
Editorial decision: Minor revision
On 09 Dec, 2019
Review #2 received
Received 07 Dec, 2019
Reviewer #2 agreed
On 28 Nov, 2019
Reviewer #1 agreed
On 26 Nov, 2019
Review #1 received
Received 26 Nov, 2019
Reviewers invited
Invitations sent on 25 Nov, 2019
Editor assigned
On 15 Nov, 2019
Submission checks complete
On 14 Nov, 2019
Editor invited
On 14 Nov, 2019
No comments provided
Editorial decision: Major revision
On 27 Oct, 2019
Reviewer #2 agreed
On 24 Oct, 2019
Review #1 received
Received 24 Oct, 2019
Reviewer #3 agreed
On 24 Oct, 2019
Review #2 received
Received 24 Oct, 2019
Reviewer #1 agreed
On 21 Oct, 2019
Reviewers invited
Invitations sent on 13 Oct, 2019
Submission checks complete
On 01 Oct, 2019
Editor assigned
On 27 Sep, 2019
Editor invited
On 26 Sep, 2019
First submitted
On 25 Sep, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Gastroenterology.
Background: A large-scale Japanese study showed that low skeletal muscle index (SMI) and intramuscular fat (IMF) deposition are associated with hepatocellular carcinoma (HCC) survival. Here, we evaluated the effects of SMI and IMF on the survival of Indonesian HCC patients, whose characteristics differ from those of Japanese patients.
Methods: SMI and mean muscle attenuation (MA) were evaluated using computed tomography images of the third lumbar vertebra (L3) in a prospective cohort of 100 Indonesian HCC patients. Clinical, laboratory and body composition data were analysed using the Kaplan–Meier method and Cox regression model to investigate which factors are associated with prognosis.
Results: Of 100 patients, 31 were diagnosed with sarcopenia (L3 SMI value ≤36.2 cm 2 /m 2 for men and ≤29.6 cm 2 /m 2 for women), and 65 had IMF deposition (MA value ≤44.4 HU for men and ≤39.3 HU for women). These groups had shorter median survival than the reference groups (both P <0.0001). In multivariable analysis, sarcopenia (hazard ratio [HR], 1.921; P = 0.016), IMF deposition (HR, 3.580; P <0.001), Barcelona Clinic Liver Cancer (BCLC) stages C and D (HR: 2.396, P <0.01 and HR: 6.131, P <0.01, respectively), Japan Integrated Staging (JIS) score 4 (HR: 2.067, P = 0.020), and male gender (HR: 3.211, P <0.001) were independently associated with mortality.
Conclusion: Sarcopenia and IMF deposition showed superior value in combination with BCLC stage and JIS score for predicting the survival of Indonesian HCC patients. Increased awareness and strategies to prevent or reverse these factors might improve patient outcomes.
Figure 1
Figure 2
Figure 3