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

被引：13

作者：

Hiraoka, Atsushi ^{[1
]}

Kumada, Takashi ^{[2
]}

Tada, Toshifumi ^{[3
]}

Hirooka, Masashi ^{[4
]}

Kariyama, Kazuya ^{[5
]}

Tani, Joji ^{[6
]}

Atsukawa, Masanori ^{[7
]}

Takaguchi, Koichi ^{[8
]}

Itobayashi, Ei ^{[9
]}

Fukunishi, Shinya ^{[10
]}

Tsuji, Kunihiko ^{[11
]}

Ishikawa, Toru ^{[12
]}

Tajiri, Kazuto ^{[13
]}

Ochi, Hironori ^{[14
]}

Yasuda, Satoshi ^{[15
]}

Toyoda, Hidenori ^{[15
]}

Ogawa, Chikara ^{[16
]}

Nishimura, Takashi ^{[17
]}

Hatanaka, Takeshi ^{[18
]}

Kakizaki, Satoru ^{[19
]}

Shimada, Noritomo ^{[20
]}

Kawata, Kazuhito ^{[21
]}

Naganuma, Atsushi ^{[22
]}

Kosaka, Hisashi ^{[23
]}

Matono, Tomomitsu ^{[24
]}

Kuroda, Hidekatsu ^{[25
]}

Yata, Yutaka ^{[26
]}

Ohama, Hideko ^{[1
]}

Tada, Fujimasa ^{[1
]}

Nouso, Kazuhiro ^{[5
]}

Morishita, Asahiro ^{[6
]}

Tsutsui, Akemi ^{[8
]}

Nagano, Takuya ^{[8
]}

Itokawa, Norio ^{[7
]}

Okubo, Tomomi ^{[7
]}

Arai, Taeang ^{[7
]}

Imai, Michitaka ^{[12
]}

Koizumi, Yohei ^{[4
]}

Nakamura, Shinichiro ^{[3
]}

Iijima, Hiroko ^{[17
]}

Kaibori, Masaki ^{[23
]}

Hiasa, Yoichi ^{[4
]}

机构：

[1] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, Matsuyama, Ehime 7900024, Japan

[2] Gifu Kyoritsu Univ, Dept Nursing, Ogaki, Japan

[3] Japanese Red Cross Himeji Hosp, Dept Internal Med, Himeji, Hyogo, Japan

[4] Ehime Univ, Dept Gastroenterol & Metabol, Grad Sch Med, Toon, Japan

[5] Okayama City Hosp, Dept Hepatol, Okayama, Japan

[6] Kagawa Univ, Dept Gastroenterol & Hepatol, Takamatsu, Kagawa, Japan

[7] Nippon Med Sch, Div Gastroenterol & Hepatol, Dept Internal Med, Tokyo, Japan

[8] Kagawa Prefectural Cent Hosp, Dept Hepatol, Takamatsu, Kagawa, Japan

[9] Asahi Gen Hosp, Dept Gastroenterol, Asahi, Japan

[10] Osaka Med & Pharmaceut Univ, Dept Gastroenterol, Osaka, Japan

[11] Teine Keijinkai Hosp, Ctr Gastroenterol, Sapporo, Hokkaido, Japan

[12] Saiseikai Niigata Hosp, Dept Gastroenterol, Niigata, Japan

[13] Toyama Univ Hosp, Dept Gastroenterol, Toyama, Japan

[14] Japanese Red Cross Matsuyama Hosp, Hepatobiliary Ctr, Matsuyama, Ehime, Japan

[15] Ogaki Municipal Hosp, Dept Gastroenterol & Hepatol, Ogaki, Japan

[16] Japanese Red Cross Takamatsu Hosp, Dept Gastroenterol, Takamatsu, Kagawa, Japan

[17] Hyogo Coll Med, Dept Gastroenterol & Hepatol, Nishinomiya, Hyogo, Japan

[18] Gunma Saiseikai Maebashi Hosp, Dept Gastroenterol, Maebashi, Gunma, Japan

[19] Natl Hosp Org Takasaki Gen Med Ctr, Dept Clin Res, Takasaki, Gumma, Japan

[20] Otakanomori Hosp, Div Gastroenterol & Hepatol, Kashiwa, Chiba, Japan

[21] Hamamatsu Univ, Hepatol Div, Dept Internal Med II, Sch Med, Hamamatsu, Shizuoka, Japan

[22] Natl Hosp Org Takasaki Gen Med Ctr, Dept Gastroenterol, Takasaki, Gumma, Japan

[23] Kansai Med Univ, Dept Surg, Hirakata, Osaka, Japan

[24] St Marys Hosp, Dept Hepatol, Himeji, Hyogo, Japan

[25] Iwate Med Univ, Sch Med, Dept Internal Med, Div Hepatol, Morioka, Iwate, Japan

[26] Hanwa Mem Hosp, Dept Gastroenterol, Osaka, Japan

来源：

HEPATOLOGY RESEARCH | 2023年 / 53卷 / 10期

关键词：

atezolizumab plus bevacizumab; geriatric nutritional risk index; modified albumin-bilirubin grade; nutrition; sarcopenia; MANAGEMENT; GUIDELINES; LENVATINIB; SORAFENIB;

D O I：

10.1111/hepr.13934

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

AimThe 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). MethodsA 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. ResultsAtez/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). ConclusionThese 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.

引用

页码：1031 / 1042

页数：12

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