부산대학교 도서관

Simple Summary: This research addresses the understudied impact of low skeletal muscle mass (LSMM) on intermediate-stage hepatocellular carcinoma (HCC) patients undergoing transcatheter liver-directed intra-arterial therapies. Aiming to determine LSMM's prevalence and its prognostic significance, the study reveals that 46% of these patients exhibit LSMM, which is consistently associated with decreased overall survival. These findings suggest the need for routine LSMM assessments in clinical settings, potentially influencing treatment strategies and clinical guidelines for HCC management, thus marking a significant contribution to the research community and patient care practices. Background and Aim: Transcatheter liver-directed intra-arterial therapies are mainstream treatment options for intermediate-stage hepatocellular carcinoma (HCC). However, the effect of low skeletal muscle mass (LSMM) on overall survival (OS) in these patients remains uncertain. We aimed to ascertain the prevalence and prognostic effect of LSMM in this population. Method: According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive search was performed in the PubMed and Embase databases until Oct 2023. Random-effects meta-analysis was performed to determine the pooled prevalence of LSMM and calculate the hazard ratio (HR) for OS with a 95% confidence interval (CI) in patients with intermediate-stage HCC undergoing various transarterial therapies, comparing those with and without LSMM. Results: Twelve studies involving 2450 patients were included. The pooled prevalence of LSMM was 46% (95% CI, 38–55%), and the results were consistent across different treatments, regions, and age subgroups. The meta-analysis indicated that LSMM was significantly associated with decreased OS (HR, 1.78; 95% CI, 1.36–2.33; I2, 75%). Subgroup analyses reassured the main findings across various therapies, including transarterial chemoembolization (TACE) (HR, 1.68; 95% CI, 1.23–2.30; I2, 81%), transarterial embolization (TAE) (HR, 2.45; 95% CI, 1.42–4.22; I2, 0%), and transarterial radioembolization (TARE) (HR, 1.94; 95% CI, 1.01–3.73; I2, 0%). Conclusions: In intermediate-stage HCC, LSMM is common and associated with reduced OS. To achieve an optimal prognosis, clinicians should incorporate routine LSMM measurement into practice, while caring for patients with intermediate-stage HCC, irrespective of TACE, TAE, and TARE. [ABSTRACT FROM AUTHOR]