Sarcopenia worsening after transarterial radioembolization with Holmium-166 predicts progressive disease in patients with advanced hepatocellular carcinoma.

Abstract

Abstract Purpose: To investigate the association between changes in sarcopenia before and after one-three months of Transarterial Radioembolization (TARE) treatment with Holmium-166 (166Ho) for hepatocellular carcinoma (HCC) and its impact on the rate of local response. Methods: A retrospective single center analysis was conducted on 20 HCC patients who underwent 166Ho-TARE. Patients were categorized into two groups based on the change in psoas muscle index (PMI) measured at the time of TARE and one-three months after: No-Sarcopenia group (deltaPMI stable or increased; n = 9) and Sarcopenia group (deltaPMI decreased; n = 7). DeltaPMI was associated to the local response rate, according to mRECIST criteria. Results: DeltaPMI was evaluated according to mRECIST criteria: non-responder group (standard and progression disease) and responder group (complete response or partial response). Three months after TARE, a significant difference in sarcopenia status was observed (p = 0.041), with a median deltaPMI of -0.57 in the non-responder and 0.12 in the responder group. DeltaPMI measured three months after TARE can be considered as a predictive biomarker of the local response rate (p=0.028). Conclusion: Sarcopenia deterioration at three months from TARE with Holmium-166 is a reliable predictor of worse loco-regional response rate, evaluated radiologically, in HCC patients.