Research Information System
Clinical Radiology, vol.95, 2026 (SCI-Expanded, Scopus)
AIM To assess the association between sarcopenia, myosteatosis, subcutaneous and visceral adipose tissue indexes and survival outcomes in patients undergoing intra-arterial therapy for hepatocellular carcinoma (HCC). MATERIALS AND METHODS In this retrospective single-centre study, HCC patients treated with transarterial chemotherapy or transarterial radiotherapy between 2012 and 2022 were enrolled. Body composition parameters were analysed on pretreatment and follow-up computed tomography (CT) images at the L3 vertebral level. The body composition parameters-survival relationship was evaluated using Kaplan-Meier analysis. Factors associated with survival were investigated using Cox regression analyses. Propensity score matching (PSM) was performed to reduce potential confounding. RESULTS A total of 160 patients were included. The mean age of patients was 63.45 ± 11.79 years, and 123 patients (76.9%) were male. Patients without sarcopenia had significantly longer progression-free survival (median PFS: 8.80 vs 2.97 months; P < 0.001) and overall survival (median OS: 19.73 vs 5.60 months; P < 0.001) compared with those with sarcopenia. Similarly, patients without myosteatosis demonstrated significantly longer PFS (median PFS: 8.57 vs 4.37 months; P = 0.003) and OS (median OS: 24.33 vs 9.47 months; P < 0.001) compared with those with myosteatosis. There was no significant relationship between subcutaneous or visceral adiposity and survival. In multivariate analysis, sarcopenia (hazard ratio [HR] = 1.59, P = 0.029), myosteatosis (HR = 1.96, P = 0.001) and larger loss of skeletal muscle index (HR = 2.13, P < 0.001) were independently associated with reduced OS. After PSM, sarcopenia (HR = 2.06, P = 0.005) and larger loss of skeletal muscle index (HR = 2.27, P = 0.002) remained poor prognostic factors for OS. CONCLUSION Baseline sarcopenia, myosteatosis and larger loss of skeletal muscle index are associated with poorer survival outcomes in patients undergoing intra-arterial therapy for HCC.