Sarcopenia, myosteatosis, and skeletal muscle loss as predictors of poor prognosis in hepatocellular carcinoma patients undergoing intra-arterial therapies.

Sarcopenia was significantly associated with shorter progression-free survival and overall survival in HCC patients undergoing intra-arterial therapy.

• Patients without sarcopenia had median PFS of 8.80 months versus 2.97 months in those with sarcopenia (P < 0.001)
• Patients without sarcopenia had median OS of 19.73 months versus 5.60 months in those with sarcopenia (P < 0.001)
• In multivariate analysis, sarcopenia was independently associated with reduced OS (HR = 1.59, P = 0.029)
• After propensity score matching, sarcopenia remained a poor prognostic factor for OS (HR = 2.06, P = 0.005)

Myosteatosis was significantly associated with shorter progression-free survival and overall survival in HCC patients undergoing intra-arterial therapy.

• Patients without myosteatosis had median PFS of 8.57 months versus 4.37 months in those with myosteatosis (P = 0.003)
• Patients without myosteatosis had median OS of 24.33 months versus 9.47 months in those with myosteatosis (P < 0.001)
• In multivariate analysis, myosteatosis was independently associated with reduced OS (HR = 1.96, P = 0.001)

Larger loss of skeletal muscle index during treatment was independently associated with reduced overall survival.

• Larger loss of skeletal muscle index was independently associated with reduced OS in multivariate analysis (HR = 2.13, P < 0.001)
• After propensity score matching, larger loss of skeletal muscle index remained a poor prognostic factor for OS (HR = 2.27, P = 0.002)
• Body composition parameters were analysed on pretreatment and follow-up CT images at the L3 vertebral level

Subcutaneous and visceral adipose tissue indexes were not significantly associated with survival outcomes.

• There was no significant relationship between subcutaneous adiposity and survival
• There was no significant relationship between visceral adiposity and survival
• This finding contrasts with the significant associations observed for sarcopenia and myosteatosis

The study enrolled 160 HCC patients treated with transarterial chemotherapy or transarterial radiotherapy at a single centre between 2012 and 2022.

• The mean age of patients was 63.45 ± 11.79 years
• 123 patients (76.9%) were male
• This was a retrospective single-centre study
• Propensity score matching was performed to reduce potential confounding
• Body composition parameters were analysed on CT images at the L3 vertebral level