Sarcopenia are Associated with Poor Performance Status in Indonesian Patients with Hepatocellular Carcinoma

Hendra Koncoro(1), Irsan Hasan(2), C Rinaldi Lesmana(3), Humala Prika Aditama(4), Thariqah Salamah(5), Aulia Rizka(6), Edy Rizal Wahyudi(7), Hamzah Shatri(8),


(1) Department of Internal Medicine, Sint Carolus Hospital, Jakarta
(2) Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta
(3) Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta
(4) Division of Musculoskeletal, Department of Radiology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
(5) Division of Musculoskeletal, Department of Radiology, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
(6) Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
(7) Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
(8) Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo General National Hospital, Jakarta
Corresponding Author

Abstract


Background: Sarcopenia affects hepatocellular carcinoma (HCC) prognosis. Sarcopenia can be assessed by using skeletal muscle index (SMI), measured on transverse CT images at the third lumbar vertebra (L3). HCC staging consists of liver function assessment and Eastern Cooperative Oncology Group performance status (ECOG-PS).                   ECOG-PS can reflect physical function. This study was aimed to describe the proportion of sarcopenia among adults, using Japan Society of Hepatology criteria and explore association between sarcopenia and poor performance status.

Method: The study was conducted in a tertiary hospital during January – October 2021. SMI were evaluated using computed tomography images of L3 in 85 HCC patients. Clinical, laboratory and body composition data were analyzed using bivariate analysis. Logistic regression was performed to obtain an independent association between ECOG-PS and sarcopenic status of HCC patients.

Results: Eighty-five HCC patients (median age, 52 years) were analyzed. Sarcopenia was observed in 49,4% of HCC patients. On multivariate binary regression analysis, a poor ECOG-PS remained independently associated with sarcopenia in HCC (adjusted OR = 4.169 (CI 95% = 1.504-11,555), p < 0,006).

Conclusion: Sarcopenia has high proportion in HCC patients. There were strong association between ECOG-PS and sarcopenia in HC.


Keywords


sarcopenia; hepatocellular carcinoma; L3-SMI; ECOG; Indonesia

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DOI: 10.24871/231202217-23

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