Model containing sarcopenia and visceral adiposity can better predict the survival of hepatocellular carcinoma: A multicenter study

Yao Liu, Sirui Fu, Xiangrong Yu, Jinxiong Zhang, Siyu Zhu, Yang Yang, Jianwen Huang, Hanlin Luo, Kai Tang, Youbing Zheng, Yujie Zhao, Xiaoqiong Chen, Meixiao Zhan, Xiaofeng He, Qiyang Li, Chongyang Duan, Yuan Chen, Ligong Lu
2023 · doi:10.21203/rs.3.rs-2438953/v1
preprint OA: closed CC-BY-4.0
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Abstract

Aim: This study aimed to explore whether the addition of sarcopenia and visceral adiposity could improve the accuracy of model predicting progression-free survival (PFS) in hepatocellular carcinoma (HCC). Methods: : In total, 394 patients with HCC from five hospitals were divided into the training and external validation datasets. Patients were initially treated by liver resection or transarterial chemoembolization. We evaluated adipose and skeletal muscle using preoperative computed tomography imaging and then constructed three predictive models, including metabolic (Model MA ), clinical–imaging (Model CI ), and combined (Model MA-CI ) models. Their discrimination, calibration, and decision curves were compared, to identify the best model. Nomogram and subgroup analysis was performed for the best model. Results: : Model MA-CI containing sarcopenia and visceral adiposity had good discrimination and calibrations(area under the curve for three-year PFS was 0.792in the training data set and 0.817 in the validation data set;similar results were achieved in one- and two-year PFS). Model MA-CI had better accuracy than Model CI and Model MA . The performance of Model MA-CI was not affected by treatments or disease stages. The high-risk subgroup(scored≥120) had a significantly shorter PFS (p<0.001) and poorer OS (p<0.001). Conclusions: : The addition of sarcopenia and visceral adiposity improved accuracy in predicting PFS in HCC, which may provide additional insights in prognosis for HCC in subsequent studies.

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License: CC-BY-4.0