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Dig Liver Dis. 2015 Oct;47(10):869-76. doi: 10.1016/j.dld.2015.07.001. Epub 2015 Jul 10.

Visceral fat area predicts survival in patients with advanced hepatocellular carcinoma treated with tyrosine kinase inhibitors.

Author information

1
APHP, Groupe Henri Mondor Albert Chenevier, Liver Unit, Henri Mondor Hospital, Créteil, France.
2
APHP, Groupe Henri Mondor Albert Chenevier, Department of Radiology, Henri Mondor Hospital, Créteil, France.
3
APHP, Groupe Hôpital Européen Georges Pompidou, Department of Clinical Research, Paris, France; INSERM, UMRS 1138, Team 22, Department of Research of Les Cordeliers, Paris, France; University Paris 5 René Descartes, Paris, France.
4
Department of Statistics, George Mason University, Fairfax, VA, USA.
5
APHP, Groupe Henri Mondor Albert Chenevier, Department of Hepatobiliary Surgery, Henri Mondor Hospital, Créteil, France; University Paris Est Créteil, Créteil, France; INSERM U955, Team 18, Créteil, France.
6
APHP, Groupe Henri Mondor Albert Chenevier, Liver Unit, Henri Mondor Hospital, Créteil, France; University Paris Est Créteil, Créteil, France; INSERM U955, Team 18, Créteil, France.
7
APHP, Groupe Henri Mondor Albert Chenevier, Department of Radiology, Henri Mondor Hospital, Créteil, France; University Paris Est Créteil, Créteil, France; INSERM U955, Team 18, Créteil, France.
8
APHP, Groupe Henri Mondor Albert Chenevier, Liver Unit, Henri Mondor Hospital, Créteil, France; University Paris Est Créteil, Créteil, France; INSERM U955, Team 18, Créteil, France. Electronic address: tdecaens@chu-grenoble.fr.

Abstract

BACKGROUND:

Anthropometric measurements have been linked to resistance to anti-angiogenic treatment and survival.

METHODS:

Patients with advanced hepatocellular carcinoma treated with sorafenib or brivanib in 2008-2011 were included in this retrospective study. Anthropometric measurements were assessed using computed tomography and were correlated with drug toxicity, radiological response, and overall survival.

RESULTS:

52 patients were included, Barcelona Clinic Liver Classification B (38%) and C (62%), with a mean value of α-fetoprotein of 29,554±85,654 ng/mL, with a median overall survival of 10.5 months. Sarcopenia was associated with a greater rate of hand-foot syndrome (P=0.049). Modified Response Evaluation Criteria In Solid Tumours (mRECIST) and Choi criteria were significantly associated with survival, but RECIST criteria were not. An absence of hand-foot syndrome and high-visceral fat area were associated with progressive disease as assessed by RECIST and mRECIST criteria. In multivariate analyses, high visceral fat area (HR=3.6; P=0.002), low lean body mass (HR=2.4; P=0.015), and presence of hand-foot syndrome (HR=1.8; P=0.004) were significantly associated with overall survival. In time-dependent multivariate analyses; only high visceral fat area was associated with survival.

CONCLUSION:

Visceral fat area is associated with survival and seems to be a predictive marker for primary resistance to tyrosine kinase inhibitors in patients with advanced hepatocellular carcinoma.

KEYWORDS:

Hepatocellular carcinoma; Sarcopenia; Sorafenib; Tyrosine kinase inhibitor; Visceral fat area

PMID:
26211871
DOI:
10.1016/j.dld.2015.07.001
[Indexed for MEDLINE]

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