The importance of body composition assessment for patients with advanced hepatocellular carcinoma by bioelectrical impedance analysis in lenvatinib treatment

• Published in: PloS one Vol. 17; no. 1; p. e0262675
• Main Authors: Yamaoka, Kenji, Kodama, Kenichiro, Kawaoka, Tomokazu, Kosaka, Masanari, Johira, Yusuke, Shirane, Yuki, Miura, Ryoichi, Yano, Shigeki, Murakami, Serami, Amioka, Kei, Naruto, Kensuke, Ando, Yuwa, Kosaka, Yumi, Uchikawa, Shinsuke, Uchida, Takuro, Fujino, Hatsue, Nakahara, Takashi, Murakami, Eisuke, Okamoto, Wataru, Yamauchi, Masami, Miki, Daiki, Imamura, Michio, Takahashi, Shoichi, Nagao, Akiko, Chayama, Kazuaki, Aikata, Hiroshi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.01.2022; Public Library of Science (PLoS)
• Subjects: Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Arm; Bioelectricity; Biology and Life Sciences; Body Composition; Body water; Cancer therapies; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Drug therapy; Electric Impedance; Female; Follow-Up Studies; Gastroenterology; Health aspects; Health sciences; Hepatitis; Hepatocellular carcinoma; Hepatology; Hepatoma; Humans; Impedance; Impedance, Bioelectric; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Male; Medical prognosis; Medicine and Health Sciences; Metabolism; Metastasis; Middle Aged; Multivariate analysis; Muscles; Musculoskeletal system; Patient outcomes; Patients; Phenylurea Compounds - therapeutic use; Prognosis; Quinolines - therapeutic use; Retrospective Studies; Sarcopenia; Skeletal muscle; Survival; Survival Rate; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0262675

The aim of this study was to investigate the relationship between body composition before lenvatinib treatment and prognosis in patients with hepatocellular carcinoma (HCC). We also assessed the relationship between the rate of change in body composition after lenvatinib treatment and prognosis. Eighty-one patients with advanced HCC who were treated with lenvatinib were enrolled. We assessed prognosis, various clinical data, body composition parameters obtained by bioelectrical impedance analysis (BIA), and handgrip strength. Multivariate analysis showed that an extracellular water to total body water ratio (ECW/TBW) ≤ 0.400 at treatment initiation was associated with longer overall survival (OS), progression-free survival (PFS), and post-progression survival (PPS) (OS: hazard ratio [H0R], 4.72; 95% CI, 12.03-11.00; P < 0.001; PFS: HR, 2.66; 95% CI, 1.33-5.34; P = 0.0057; PPS: HR, 3.08; 95% CI, 1.32-7.18; P = 0.0093). Multivariate analysis also showed that the skeletal muscle mass index (SMI) of the arm at treatment initiation was associated with a longer PFS (HR, 2.12; 95% CI, 1.23-3.64; P = 0.0069). In the group with an ECW/TBW ≤ 0.400 before lenvatinib treatment, univariate analysis showed that the rate of change in only the arm SMI was associated with a longer OS and PFS. Body composition assessment by BIA before and after lenvatinib treatment is useful in predicting prognosis in lenvatinib-treated patients with HCC.