肌少症对肝细胞癌 (HCC) 结局的影响已有充分记录，但肌少症前期的影响仍不清楚。本研究探讨了肌少症前期对接受经动脉化疗栓塞 (TACE) 的不可切除 HCC 患者的肿瘤反应和生存的影响。我们使用 SliceOmatic 软件回顾性评估了接受 TACE 治疗的不可切除 HCC 患者的肌肉体积。肌少症前期由日本肝病学会标准定义（男性：42 cm2/m2；女性：38 cm2/m2）。比较肌少症前期组和非肌少症前期组，并使用 Cox 比例风险模型来确定影响生存的变量。使用血清甲胎蛋白 (AFP) 水平（诊断截止值为 200 ng/mL）按肿瘤负荷分层进行亚组分析。在 100 名患者中，39 名患有肌少症前期。前肌少症的存在与肿瘤完全缓解的实现无关。肌少症前期组（18 个月）的中位总生存期 (OS) 显着低于非肌少症前期组（30 个月；对数秩 P = 0.039）。对 77 名 AFP< 200 ng/mL 的患者进行的亚组分析显示，肌少症前期组的 OS 特别差（16 个月与 34 个月；对数秩 P< 0.001）。多变量分析发现 AFP 增加（调整后的风险比 [HR] 每增加 10 个单位 1.142；P < 0.001），终末期肝病模型评分更高（调整后的 HR 每增加 1.176；P< 0.001），并且预-肌少症（调整后的 HR 2.965；P < 0.001）作为较短 OS 的预测因子。肌少症前期是接受 TACE 的不可切除 HCC 患者死亡率增加的重要预测因子，尤其是 AFP< 200 ng/mL 的患者，表明其作为早期干预目标的潜力。© 2024。作者。

Sarcopenia's impact on hepatocellular carcinoma (HCC) outcomes is well-documented, but the effects of pre-sarcopenia remain unclear. This study investigates the impact of pre-sarcopenia on tumor response and survival in patients with unresectable HCC undergoing transarterial chemoembolization (TACE). We retrospectively evaluated muscle volume using the SliceOmatic software in patients with unresectable HCC treated with TACE. Pre-sarcopenia was defined by Japan Society of Hepatology standards (men: 42 cm2/m2; women: 38 cm2/m2). Pre-sarcopenia and non-pre-sarcopenia groups were compared, and Cox proportional hazards model was used to identify survival-influencing variables. Subgroup analysis was conducted stratified by the tumor burden, using serum alpha-fetoprotein (AFP) levels at a diagnostic cutoff value of 200 ng/mL. Of the 100 patients, 39 had pre-sarcopenia. The presence of pre-sarcopenia was not associated with tumor complete response achievement. The median overall survival (OS) was significantly lower in the pre-sarcopenia group (18 months) than in the non-pre-sarcopenia group (30 months; log-rank P = 0.039). Subgroup analysis among 77 patients with AFP < 200 ng/mL revealed that OS was particularly poor in the pre-sarcopenia group (16 vs. 34 months; log-rank P < 0.001). Multivariate analysis identified increased AFP (adjusted hazard ratio [HR] per 10-unit increase 1.142; P < 0.001), higher Model for End-Stage Liver Disease score (adjusted HR per 1-unit increase 1.176; P < 0.001), and pre-sarcopenia (adjusted HR 2.965; P < 0.001) as predictors of shorter OS. Pre-sarcopenia is a significant predictor of increased mortality in patients with unresectable HCC undergoing TACE, especially in those with AFP < 200 ng/mL, suggesting its potential as a target for early intervention.© 2024. The Author(s).