Transarterial chemoembolization(TACE) is the suggested treatment for hepatocellular carcinoma (HCC) not amenable to curative treatments. We investigated the role of sarcopenia on overall survival in HCC patients receiving TACE and proposed a new prognostic scoring system incorporating sarcopenia.

We retrospectively analyzed 260 HCC patients who received TACE between 2010 and 2015. Total psoas muscle was measured on a cross-sectional CT image before the first TACE session. Sarcopenia was defined by the pre-determined sex-specific cutoff value. We assessed the impact of sarcopenia and other biochemical factors on the overall survival and compared the new scoring system with other prognostic scoring systems.

One hundred and thirty patients (50%) were classified as sarcopenia before the first TACE. They were older with a higher male tendency and a significantly lower body mass index (BMI). Cox regression multivariate analysis demonstrated that sarcopenia, multiple tumors, maximal tumor diameter≥ 5cm, major venous thrombosis, sarcopenia, AFP ≥ 200 ng/ml, and albumin<3.5mg/dL were independent poor prognostic factors for overall survival in HCC patients receiving TACE. Our scoring system comprising these factors outperformed other major scoring systems in terms of predicting survival after TACE.

The current study demonstrated that sarcopenia was an independent prognostic factor for HCC undergoing TACE therapy. Our newly developed scoring system could effectively predict patient survival after TACE. Physicians could, based on the current score model, carefully select candidate patients for TACE treatment in order to optimize their survival. Further studies are warranted to validate our findings.

经动脉化疗栓塞术 (TACE) 是不适合治愈性治疗的肝细胞癌 (HCC) 的建议治疗方法。我们调查了肌肉减少症对接受 TACE 的 HCC 患者总体生存的作用，并提出了一种新的包含肌肉减少症的预后评分系统。

我们回顾性分析了 2010 年至 2015 年间接受 TACE 的 260 名 HCC 患者。在第一次 TACE 治疗之前，在横断面 CT 图像上测量了总腰大肌。肌肉减少症由预先确定的性别特异性截止值定义。我们评估了肌肉减少症和其他生化因素对总生存期的影响，并将新评分系统与其他预后评分系统进行了比较。

在第一次 TACE 之前，130 名患者 (50%) 被归类为肌肉减少症。他们年龄更大，男性倾向更高，体重指数（BMI）显着降低。Cox回归多元分析表明，肌肉减少、多发肿瘤、最大肿瘤直径≥5cm、主要静脉血栓形成、肌肉减少、AFP≥200 ng/ml和白蛋白<3.5mg/dL是接受TACE治疗的HCC患者总生存期的独立不良预后因素. 我们包含这些因素的评分系统在预测 TACE 后的生存率方面优于其他主要评分系统。

目前的研究表明，肌肉减少症是接受 TACE 治疗的 HCC 的独立预后因素。我们新开发的评分系统可以有效预测 TACE 后患者的存活率。医生可以根据当前的评分模型，仔细选择 TACE 治疗的候选患者，以优化他们的生存。需要进一步的研究来验证我们的发现。