164P - The impact of sarcopenia on chemotherapy toxicity and survival rate among hepatocellular carcinoma patients who underwent chemotherapy: A systematic review and meta-analysis

Background

Sarcopenia is the loss of skeletal muscle mass and function that occurs with advancing age and certain diseases. It is a complication and independent risk factor for chemotherapy toxicity and mortality in patients with liver cirrhosis and hepatocellular carcinoma. The aim of this study was to study the impact of sarcopenia on chemotherapy toxicity and survival among hepatocellular carcinoma patients who underwent chemotherapy.

Methods

A systematic review was performed according to PRISMA guidelines. A literature search was conducted by two independent reviewers on all studies that included sarcopenia in hepatocellular carcinoma patients who underwent chemotherapy using PubMed, PubMed central, and Google Scholar databases. Study included elderly population was excluded. Outcome of interest included chemotherapy toxicity and overall survival. Data synthesis and statistical analysis were carried out using Review Manager software.

Results

A total of 10 studies were eligible for meta-analysis including a total of 1203 hepatocellular carcinoma patients. All included studies were retrospective cohort. Meta-analysis revealed a significant association between sarcopenia and overall survival (HR 1.76; 95% CI 1.37 – 2.25; P < 0.001). Sarcopenia was also associated with incidence of chemotherapy toxicity (OR 2.84; 95% CI 1.35 – 5.96; P = 0.006), including hand-foot syndrome, diarrhea, hepatic encephalopathy and hypertension. The quality of study assessed with Newcastle Ottawa Scale (NOS) showed “poor” in only 2 included studies while the remaining 8 studies were graded as “good”.

Conclusions

Sarcopenia can give negative impact on chemotherapy toxicities and survival outcomes for hepatocellular carcinoma patients who underwent chemotherapy. Prospective studies with a uniform definition of sarcopenia and same chemotherapy regimen are still needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.