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.

本数据集收录了与题为《肌肉减少症（sarcopenia）作为不可切除肝细胞癌（hepatocellular carcinoma, HCC）患者行单纯经动脉栓塞术的生存预测因子》的研究相关数据。

肌肉减少症已被证实与接受手术切除、经动脉化疗栓塞术（transarterial chemoembolization, TACE）、经动脉放射栓塞术（transarterial radioembolization, TARE）或肝移植的肝硬化及肝细胞癌患者的总体生存率降低相关。本项单中心研究通过分析肌肉减少症对生存及治疗相关并发症的影响，评估了肝细胞癌患者接受单纯经动脉栓塞术（bland transarterial embolization, TAE）治疗时，肌肉减少症的预后价值。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。为评估肌肉减少症，研究人员于栓塞术前通过腹部CT扫描测量L3椎体水平的横断面肌肉面积（单位：cm²），并以患者身高（单位：m²）对其进行标准化，计算得到骨骼肌指数（skeletal muscle index, SMI）。肌肉减少症的截断值设定为：女性≤39 cm²/m²，男性≤55 cm²/m²。研究收集了患者的年龄、性别、体质量指数（body mass index, BMI）、基础肝脏疾病、肝功能、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、体能状态、既往干预措施、住院时长（length of stay, LOS）、术后并发症、30天内再入院率、TAE术后生存时间，以及首次术后接受的TAE治疗总次数与类型等数据。

2011年至2019年间，共计142例连续性患者接受了305次TAE治疗。观察时长范围为1.4至100.5个月（中位时长20.1，标准差为22）。基线时存在肌肉减少症的患者共121例，占比85%。随访期间共有87例（61.2%）患者死亡，1年、2年、3年、4年及5年生存率分别为71%、41%、22%、16%及11%。经多变量分析后发现，肌肉减少症（风险比HR=2.22，p=0.046）、既往消融/切除术（HR=0.51，p=0.005）以及多灶性疾病（HR=1.84，p=0.02）与生存率降低显著相关。肌肉减少症对TAE治疗的安全性无显著影响，具体体现在住院时长（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30天内再入院率（7% vs 5%，p=0.74）均无统计学差异。通过L3-SMI法评估的肌肉减少症是接受单纯TAE治疗的肝细胞癌患者的一项新兴预后因子，其与死亡率升高相关，但不会影响该局部治疗的安全性。针对骨骼肌指数的改善措施（如营养支持与体育锻炼），应在接受肝脏栓塞术的肝细胞癌患者中开展临床试验，以评估其对总体生存率的影响。