Geriatric nutritional risk index as an easy‐to‐use assessment tool for nutritional status in hepatocellular carcinoma treated with atezolizumab plus bevacizumab

医学 肝细胞癌 内科学 阿替唑单抗 贝伐单抗 肿瘤科 癌症 化疗 无容量 免疫疗法
作者
Atsushi Hiraoka,Takashi Kumada,Toshifumi Tada,Masashi Hirooka,Kazuya Kariyama,Joji Tani,Masanori Atsukawa,Koichi Takaguchi,Ei Itobayashi,Shinya Fukunishi,Kunihiko Tsuji,Toru Ishikawa,Kazuto Tajiri,Hironori Ochi,Satoshi Yasuda,Hidenori Toyoda,Chikara Ogawa,Takashi Nishimura,Takeshi Hatanaka,Satoru Kakizaki
出处
期刊:Hepatology Research [Wiley]
卷期号:53 (10): 1031-1042 被引量:16
标识
DOI:10.1111/hepr.13934
摘要

The present study focused on Geriatric Nutritional Risk Index (GNRI), which is based on bodyweight and serum albumin, and known as an easy-to-use nutritional assessment tool in clinical settings, to elucidate the prognostic predictive ability of GNRI in patients treated with atezolizumab plus bevacizumab (Atez/Bev) for hepatocellular carcinoma (HCC).A total of 525 HCC patients treated with Atez/Bev, based on their classification of unsuitable status for curative treatments and/or transarterial catheter chemoembolization, were enrolled (Child-Pugh A:B:C = 484:40:1, Barcelona Clinic Liver Cancer stage 0:A:B:C:D = 7:25:192:283:18). Prognosis was evaluated retrospectively using GNRI.Atez/Bev was used in 338 of the present cohort as first-line systemic chemotherapy (64.4%). Median progression-free survival based on GNRI indicating normal, mild decline, moderate decline, and severe decline was 8.3, 6.7, 5.3, and 2.4 months, respectively, whereas median overall survival was 21.4, 17.0, 11.5. and 7.3 months, respectively (both p < 0.001). The concordance index (c-index) values of GNRI for predicting prognosis (progression-free survival/overall survival) were superior to those of Child-Pugh class and albumin-bilirubin grade (0.574/0.632 vs. 0.527/0.570 vs. 0.565/0.629). As a subanalysis, muscle volume loss was observed in 37.5% of 256 patients with computed tomography data available. Along with GNRI decline, frequency of muscle volume loss became progressively larger (normal vs. mild vs. moderate vs. severe = 17.6% vs. 29.2% vs. 41.2% vs. 57.9%, p < 0.001), and a GNRI value of 97.8 was predictive of its occurrence (AUC 0.715, 95% CI 0.649-0.781; specificity/sensitivity = 0.644/0.688).These findings indicate that GNRI is an effective nutritional prognostic tool for predicting prognosis and muscle volume loss complication in HCC patients treated with Atez/Bev.
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