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MRI-Derived Sarcopenia Associated with Increased Mortality Following Yttrium-90 Radioembolization of Hepatocellular Carcinoma

  • Clinical Investigation
  • Interventional Oncology
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the influence of sarcopenia on survival in patients with hepatocellular carcinoma (HCC) treated with 90Y radioembolization.

Materials and Methods

This single-center retrospective cohort study analyzed 82 consecutive patients (65 men and 17 women, mean age 65 years, range 31–83 years) with HCC treated with 90Y radioembolization between December 2013 and December 2017. Sarcopenia was assessed on pre-procedure MRI performed within 100 days prior to 90Y radioembolization by segmenting the paraspinal musculature at the level of the superior mesenteric artery origin and subtracting fat-intensity pixels to yield fat-free muscle area (FFMA). Sarcopenia was defined as FFMA ≤31.97 cm2 for men and ≤28.95 cm2 for women. Survival at 90 days, 180 days, 1 year, and 3 years following initial treatment was assessed using medical and public obituary records.

Results

Sarcopenia was identified in 30% (25/82) of patients. Death was reported for 49% (32/65) of males and 71% (8/17) of females (mean follow-up 19.6 months, range 21 days–58 months). Patients with sarcopenia were found to have increased mortality at 180 days (31.8% vs. 8.9%) and 1 year (68.2% vs. 21.2%). Sarcopenia was an independent predictor of mortality adjusted for BCLC stage and sub-analysis demonstrated that sarcopenia independently predicted increased mortality for patients with BCLC stage B disease.

Conclusion

Sarcopenia was associated with increased 180-day and 1-year mortality in HCC patients undergoing 90Y radioembolization. Sarcopenia was an independent predictor of survival adjusted for BCLC stage with significant deviation in the survival curves of BCLC stage B patients with and without sarcopenia.

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Acknowledgements

Asdas.

Funding

The authors did not receive any support from any organization for the submitted work.

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Authors and Affiliations

  1. Division of Interventional Radiology, Department of Radiology, NYU Langone Health, 660 First Avenue, 3rd Floor, New York, NY, 10016, USA

    Phillip L. Guichet, Bedros Taslakian, Chenyang Zhan, Sean Farquharson, Ryan Hickey, Cash J. Horn & Jonathan S. Gross

  2. Department of Radiology, Denver Health, 777 Bannock St., Pavilion A, Denver, CO, 80204, USA

    Eric Aaltonen

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  1. Phillip L. Guichet
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  2. Bedros Taslakian
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  3. Chenyang Zhan
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Correspondence to Phillip L. Guichet.

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Conflict of interest

Author Ryan Hickey is a consultant for and has received a speaking fee from Boston Scientific. The remaining authors have no financial or non-financial interests to disclose.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. This article does not contain any studies with animals performed by any of the authors. This single-center, retrospective cohort study was approved by the local Institutional Review Board.

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This study has obtained IRB approval from the Institutional Review Board of New York University Grossman School of Medicine and the need for informed consent was waived.

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Guichet, P.L., Taslakian, B., Zhan, C. et al. MRI-Derived Sarcopenia Associated with Increased Mortality Following Yttrium-90 Radioembolization of Hepatocellular Carcinoma. Cardiovasc Intervent Radiol 44, 1561–1569 (2021). https://doi.org/10.1007/s00270-021-02874-6

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  • DOI: https://doi.org/10.1007/s00270-021-02874-6

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