Body Composition as a Novel Prognostic Biomarker for the Patients with Advanced Hepatocellular Carcinoma

Abstract

Several systemic therapeutic options have been developed for treatment of advanced hepatocellular carcinoma（HCC）in recent years. The sequential use of adequate key drugs is recommended to prolong survival. As there has been no established predictive biomarker of individual drug efficacy, a simple biomarker to predict drug efficacy and prognosis is required. In this study, we investigated the impact of body composition, i.e., skeletal muscle and visceral fat content, on the prognosis of advanced HCC patients treated with sorafenib. We identified ‘no muscle depletion with high visceral fat area’as a novel predictive biomarker. In contrast, the body composition was not found to be a prognostic factor in patients treated with hepatic arterial infusion chemotherapy（HAIC），which is also treatment option for advanced HCC, but could be a useful biomarker when selecting between sorafenib and HAIC. Furthermore, in a multicenter study, we demonstrated that skeletal muscle volume was an independent predictor of survival after sorafenib treatment failure in HCC patients. In conclusion, skeletal muscle volume may prove to be one of the crucial factors in selecting sequential therapies in advanced HCC patients.