Cachexia Index as a Prognostic Indicator in Patients with Unresectable Hepatocellular Carcinoma Receiving Atezolizumab and Bevacizumab Therapy.

IF 1.8 3区医学 Q3 ONCOLOGY Oncology Pub Date : 2026-01-01 Epub Date: 2025-03-28 DOI:10.1159/000544979

Khanh Van Nguyen, Kosuke Matsui, Hisashi Kosaka, Hideyuki Matsushima, Hidekazu Yamamoto, Tung Thanh Lai, Kyoko Inoue, Moriyasu Takada, Fujimasa Tada, Atsushi Hiraoka, Takeshi Hatanaka, Toshifumi Tada, Takashi Kumada, Hiroki Kato, Kengo Yoshii, Takashi Yamaguchi, Shinji Shimoda, Makoto Naganuma, Masaki Kaibori

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Abstract

Introduction: We investigated the association between the pretreatment cachexia index (CXI) and survival outcomes in patients with unresectable hepatocellular carcinoma (u-HCC) receiving atezolizumab plus bevacizumab (Atez/Bev).

Methods: We conducted a retrospective analysis of 195 patients with u-HCC treated with Atez/Bev from September 2020 to December 2023. The skeletal muscle mass index (SMI) was calculated by normalizing the psoas muscle area by the square of the height (cm2/m2). The CXI was defined as the SMI × serum albumin level (g/dL)/neutrophil-to-lymphocyte ratio. Propensity score matching (PSM) was applied to minimize the effect of potential confounders. Associations between CXI, overall survival (OS), and progression-free survival (PFS) were assessed.

Results: From the initial cohort, CXI cutoffs of 7.23 for males and 4.99 for females were established. PSM matched 60 pairs of patients with low and high CXI, showing no significant differences in confounding factors between groups. Kaplan-Meier analysis indicated that the low CXI group had shorter median OS (12.5 vs. 26.1 months, p = 0.009) and PFS (6.1 vs. 11.1 months, p = 0.045) compared with the high CXI group. No significant differences existed between groups in overall response rate (p = 0.994) and disease control rate (p = 0.090). Multivariate Cox proportional hazards analysis identified low CXI as an independent prognostic factor for OS (HR: 1.89, 95% CI: 1.11-3.22, p = 0.019) and PFS (HR: 1.53, 95% CI: 1.01-2.34, p = 0.047).

Conclusions: The CXI may be a valuable prognostic tool for predicting survival outcomes in patients with u-HCC receiving Atez/Bev.

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恶病质指数作为不可切除肝细胞癌患者接受阿特唑单抗和贝伐单抗治疗的预后指标

背景和目的：我们研究了接受atezolizumab + bevacizumab （Atez/Bev）治疗的不可切除肝细胞癌（u-HCC）患者的预处理恶病质指数（CXI）与生存结局之间的关系。方法：我们对2020年9月至2023年12月期间接受Atez/Bev治疗的195例u-HCC患者进行了回顾性分析。骨骼肌质量指数（SMI）由腰大肌面积归一化后的高度平方（cm²/m²）计算。CXI定义为SMI ×血清白蛋白水平(g/dL)/中性粒细胞与淋巴细胞比值。使用倾向评分匹配（PSM）来最小化潜在混杂因素的影响。评估CXI、总生存期（OS）和无进展生存期（PFS）之间的关系。结果：从初始队列开始，CXI临界值为男性7.23，女性4.99。PSM匹配60对低CXI和高CXI患者，组间混杂因素无显著差异。Kaplan-Meier分析显示，与高cxi组相比，低cxi组的中位OS（12.5个月对26.1个月，p = 0.009）和PFS（6.1个月对11.1个月，p = 0.045）较短。两组总有效率（p = 0.994）和疾病控制率（p = 0.090）差异无统计学意义。多因素Cox比例风险分析发现，低CXI是OS （HR: 1.89, 95% CI: 1.11-3.22, p = 0.019）和PFS （HR: 1.53, 95% CI: 1.01-2.34, p = 0.047）的独立预后因素。结论：CXI可能是预测接受Atez/Bev治疗的u-HCC患者生存结果的有价值的预后工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology 医学-肿瘤学

CiteScore

6.00

自引率

2.90%

发文量

审稿时长

6-12 weeks

期刊介绍： Although laboratory and clinical cancer research need to be closely linked, observations at the basic level often remain removed from medical applications. This journal works to accelerate the translation of experimental results into the clinic, and back again into the laboratory for further investigation. The fundamental purpose of this effort is to advance clinically-relevant knowledge of cancer, and improve the outcome of prevention, diagnosis and treatment of malignant disease. The journal publishes significant clinical studies from cancer programs around the world, along with important translational laboratory findings, mini-reviews (invited and submitted) and in-depth discussions of evolving and controversial topics in the oncology arena. A unique feature of the journal is a new section which focuses on rapid peer-review and subsequent publication of short reports of phase 1 and phase 2 clinical cancer trials, with a goal of insuring that high-quality clinical cancer research quickly enters the public domain, regardless of the trial’s ultimate conclusions regarding efficacy or toxicity.