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Objectives <p>To investigate baseline patient characteristics associated with the risk of computed tomography (CT)-based sarcopenia and assess whether sarcopenia and other morphometric parameters influence survival outcomes in patients with liver metastases and cholangiocarcinoma after Yttrium-90 radioembolization.</p> Materials and methods <p>We retrospectively analyzed 120 cancer patients (mean age, 62 ± 13.3 years, 61 men) who underwent preprocedural CT. Skeletal muscle index (SMI) was measured at the L3 vertebral level to identify sarcopenia. The Cox proportional hazard model was performed to assess the prognostic value of the variables, and Kaplan–Meier analysis with log-rank text was used for overall survival (OS) assessment.</p> Results <p>Sarcopenia was diagnosed in 70 patients (58.3%). The multivariate regression analysis demonstrated that male&#xa0;sex, body mass index (BMI), visceral fat radiation attenuation (VFRA), skeletal muscle radiation attenuation (SMRA), and subcutaneous fat radiation attenuation (SFRA) were associated with the incidence of sarcopenia with the odds ratio of 8.81 (95% CI, 2.09–37.1, <i>p</i> = 0.003), 0.64 (95% CI, 0.48–0.85, <i>p</i> = 0.002), 1.23 (95% CI, 1.06–1.42, <i>p</i> = 0.006), 0.79 (95% CI, 0.69–0.91, <i>p</i> = 0.001) and 0.84 (95% CI, 0.76–0.93, <i>p</i> = 0.001), respectively. Age, skeletal muscle index, and tumor subtypes were independent prognostic factors for OS with the hazard ratio of 1.03 (95% CI, 1.01–1.05, <i>p</i> = 0.01), 0.92 (95% CI, 0.86–0.99, <i>p</i> = 0.021) and 2.09 (95% CI, 1.31–3.33 <i>p</i> = 0.002), respectively. In patients with intrahepatic cholangiocarcinoma, median OS was significantly longer in the&#xa0;non-sarcopenic group than in the sarcopenic patient (25.9 versus 6.5 months, <i>p</i> = 0.029).</p> Conclusion <p>Male&#xa0;sex, BMI, VFRA, SMRA, and SFRA were associated with the incidence of sarcopenia. SMI value could be used as a biomarker for OS in patients treated with Yttrium-90 radioembolization.</p> Key Points <p><Emphasis Type="BoldItalic">Question</Emphasis> <i>The prognostic significance of CT-based sarcopenia and other morphometric parameters in patients with liver metastases and cholangiocarcinoma undergoing Yttrium-90 radioembolization remains unclear.</i></p> <p><Emphasis Type="BoldItalic">Findings</Emphasis> <i>A high skeletal muscle index has been identified as an independent protective factor for overall survival in cancer patients treated with Yttrium-90 radioembolization.</i></p> <p><Emphasis Type="BoldItalic">Clinical relevance</Emphasis> <i>The negative impact of CT-based sarcopenia has been confirmed in the context of Yttrium-90 radioembolization. Clinicians should strive to prevent the progression of sarcopenia or maintain skeletal muscle index in perioperative management.</i></p>

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Prognostic value of CT-based skeletal muscle and adipose tissue mass and quality parameters in patients with liver metastases and intrahepatic cholangiocarcinoma undergoing Yttrium-90 radioembolization

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月21日

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  • Yan Zhao,
  • Fabio Becce,
  • Romain Balmer,
  • Ricardo H. do Amaral,
  • Yasser Alemán-Gómez,
  • Emilie Uldry,
  • Montserrat Fraga,
  • Georgia Tsoumakidou,
  • Nicolas Villard,
  • Alban Denys,
  • Antonia Digklia,
  • Niklaus Schaefer,
  • Rafael Duran

摘要

Objectives

To investigate baseline patient characteristics associated with the risk of computed tomography (CT)-based sarcopenia and assess whether sarcopenia and other morphometric parameters influence survival outcomes in patients with liver metastases and cholangiocarcinoma after Yttrium-90 radioembolization.

Materials and methods

We retrospectively analyzed 120 cancer patients (mean age, 62 ± 13.3 years, 61 men) who underwent preprocedural CT. Skeletal muscle index (SMI) was measured at the L3 vertebral level to identify sarcopenia. The Cox proportional hazard model was performed to assess the prognostic value of the variables, and Kaplan–Meier analysis with log-rank text was used for overall survival (OS) assessment.

Results

Sarcopenia was diagnosed in 70 patients (58.3%). The multivariate regression analysis demonstrated that male sex, body mass index (BMI), visceral fat radiation attenuation (VFRA), skeletal muscle radiation attenuation (SMRA), and subcutaneous fat radiation attenuation (SFRA) were associated with the incidence of sarcopenia with the odds ratio of 8.81 (95% CI, 2.09–37.1, p = 0.003), 0.64 (95% CI, 0.48–0.85, p = 0.002), 1.23 (95% CI, 1.06–1.42, p = 0.006), 0.79 (95% CI, 0.69–0.91, p = 0.001) and 0.84 (95% CI, 0.76–0.93, p = 0.001), respectively. Age, skeletal muscle index, and tumor subtypes were independent prognostic factors for OS with the hazard ratio of 1.03 (95% CI, 1.01–1.05, p = 0.01), 0.92 (95% CI, 0.86–0.99, p = 0.021) and 2.09 (95% CI, 1.31–3.33 p = 0.002), respectively. In patients with intrahepatic cholangiocarcinoma, median OS was significantly longer in the non-sarcopenic group than in the sarcopenic patient (25.9 versus 6.5 months, p = 0.029).

Conclusion

Male sex, BMI, VFRA, SMRA, and SFRA were associated with the incidence of sarcopenia. SMI value could be used as a biomarker for OS in patients treated with Yttrium-90 radioembolization.

Key Points

Question The prognostic significance of CT-based sarcopenia and other morphometric parameters in patients with liver metastases and cholangiocarcinoma undergoing Yttrium-90 radioembolization remains unclear.

Findings A high skeletal muscle index has been identified as an independent protective factor for overall survival in cancer patients treated with Yttrium-90 radioembolization.

Clinical relevance The negative impact of CT-based sarcopenia has been confirmed in the context of Yttrium-90 radioembolization. Clinicians should strive to prevent the progression of sarcopenia or maintain skeletal muscle index in perioperative management.