Dataset related to article: " Sarcopenia as a predictor of survival in patients undergoing bland transarterial embolization for unresectable hepatocellular carcinoma"

This record contains data related to article " Sarcopenia as a predictor of survival in patients undergoing bland transarterial embolization for unresectable hepatocellular carcinoma" Sarcopenia has been associated with lower overall survival in patients wth cirrhosis and hepatocellular carcinoma (HCC) undergoing surgical resection, TACE, TARE, or transplantation. This monocentric study evaluated the prognostic significance of sarcopenia in patients affected by HCC who received bland transarterial embolization (TAE) therapy, by analyzing its impact on survival and treatment-related complications. All consecutive patients who underwent the 1st TAE between March 1st 2011 and July 1st 2019 in our Institution were retrospectively studied. To evaluate sarcopenia, the skeletal muscle index (SMI) was calculated by normalizing the cross-sectional muscle area at the level of L3 on an abdominal CT scan prior to embolization (cm2) by patient height (m2). SMI cut-off values for sarcopenia were considered ≤ 39 cm2/m2 for women and ≤55 cm2/m2 for men. Data about age, gender, body mass index (BMI), underlying liver disease, liver function, MELD score, Child-Pugh score, multifocal disease, performance status, previous interventions, length of stay (LOS), complications after the procedure, readmission rate within 30 days, survival time from TAE and total number and type of TAE received following the first procedure were collected. From 2011 to 2019, 142 consecutive patients underwent 305 TAEs. Observation time ranged from 1.4 to 100.5 months (median 20.1 SD = 22). Sarcopenia at baseline was present in 121 (85%) patients. Overall 87 (61.2%) patients died during follow-up with survival rates at 1-, 2-, 3-, 4-, and 5-year of 71%, 41%, 22%, 16% and 11% respectively. After multivariate analysis sarcopenia (HR = 2.22, p = 0.046), previous ablation/resection (HR = 0.51, p = 0.005) and multifocal disease (HR = 1.84, p = 0.02) were associated with reduced survival. Sarcopenia did not influence the safety of TAE in terms of LOS (2 days vs 1.5 days, p = 0.2), early complications rate (8% vs 5%, p = 0.5) and readmission rate within 30 days (7% vs 5%, p = 0.74). Sarcopenia, estimated by the L3SMI method, is an emerging prognostic factor in patients with HCC undergoing bland TAE therapy as it is associated with increased mortality, without impairing the safety of the locoregional treatment. Measures to ameliorate the SMI, such as nutritional support and physical exercise, should be evaluated in clinical trials for HCC patients receiving liver embolization to determine their impact on overall survival.本数据集收录与论文《肌少症作为不可切除肝细胞癌患者行单纯经动脉栓塞术的预后生存预测因子》相关的研究数据。肌少症（sarcopenia）已被证实与接受手术切除、经动脉化疗栓塞（transarterial chemoembolization, TACE）、经动脉放射栓塞（transarterial radioembolization, TARE）或肝移植的肝硬化及肝细胞癌（hepatocellular carcinoma, HCC）患者的总体生存率降低相关。本项单中心研究针对接受单纯经动脉栓塞（bland transarterial embolization, TAE）治疗的肝细胞癌患者，分析肌少症对其生存结局及治疗相关并发症的影响，以评估肌少症的预后价值。本研究回顾性分析了2011年3月1日至2019年7月1日期间在本机构接受首次TAE治疗的所有连续性患者。肌少症的评估采用骨骼肌指数（skeletal muscle index, SMI）：术前栓塞时通过腹部CT扫描测量L3椎体水平的横断面肌肉面积（单位：cm²），再以患者身高（单位：m²）进行标准化计算。肌少症的截断值设定为：女性≤39 cm²/m²，男性≤55 cm²/m²。研究收集的临床资料包括：年龄、性别、体质量指数（body mass index, BMI）、基础肝病情况、肝功能指标、终末期肝病模型（model for end-stage liver disease, MELD）评分、Child-Pugh评分、多灶性疾病状态、体能状态、既往干预史、住院时长（length of stay, LOS）、术后并发症情况、术后30天再入院率、TAE术后生存时间，以及首次TAE术后接受的TAE总次数与类型。2011年至2019年间，共计142例连续性患者接受了305次TAE治疗。患者的随访时长范围为1.4~100.5个月（中位时长20.1个月，标准差22）。基线时存在肌少症的患者共121例，占比85%。随访期间共计87例（61.2%）患者死亡，1年、2年、3年、4年及5年总体生存率分别为71%、41%、22%、16%和11%。多因素回归分析结果显示，肌少症（风险比HR=2.22，P=0.046）、既往接受消融/切除术（HR=0.51，P=0.005）以及多灶性疾病（HR=1.84，P=0.02）与患者生存时间缩短显著相关。肌少症并未对TAE治疗的安全性产生显著影响：在住院时长（2天 vs 1.5天，P=0.2）、早期并发症发生率（8% vs 5%，P=0.5）以及术后30天再入院率（7% vs 5%，P=0.74）方面均无统计学差异。通过L3骨骼肌指数法评估的肌少症是接受单纯TAE治疗的肝细胞癌患者的新型预后因子，其与患者死亡率升高显著相关，但并不会影响该局部治疗的安全性。针对接受肝脏栓塞治疗的肝细胞癌患者，可通过临床试验评估改善骨骼肌指数的干预措施（如营养支持与体育锻炼）对其总体生存率的影响。