TY - JOUR
T1 - Low bone mineral density is a prognostic factor for elderly patients with HCC undergoing TACE
T2 - results from a multicenter study
AU - Müller, Lukas
AU - Mähringer-Kunz, Aline
AU - Auer, Timo Alexander
AU - Fehrenbach, Uli
AU - Gebauer, Bernhard
AU - Haubold, Johannes
AU - Theysohn, Jens M.
AU - Kim, Moon Sung
AU - Kleesiek, Jens
AU - Diallo, Thierno D.
AU - Eisenblätter, Michel
AU - Bettinger, Dominik
AU - Steinle, Verena
AU - Mayer, Philipp
AU - Zopfs, David
AU - Pinto dos Santos, Daniel
AU - Kloeckner, Roman
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2023/2
Y1 - 2023/2
N2 - Objectives: Low bone mineral density (BMD) was recently identified as a novel risk factor for patients with hepatocellular carcinoma (HCC). In this multicenter study, we aimed to validate the role of BMD as a prognostic factor for patients with HCC undergoing transarterial chemoembolization (TACE). Methods: This retrospective multicenter trial included 908 treatment-naïve patients with HCC who were undergoing TACE as a first-line treatment, at six tertiary care centers, between 2010 and 2020. BMD was assessed by measuring the mean Hounsfield units (HUs) in the midvertebral core of the 11th thoracic vertebra, on contrast-enhanced computer tomography performed before treatment. We assessed the influence of BMD on median overall survival (OS) and performed multivariate analysis including established estimates for survival. Results: The median BMD was 145 HU (IQR, 115–175 HU). Patients with a high BMD (≥ 114 HU) had a median OS of 22.2 months, while patients with a low BMD (< 114 HU) had a lower median OS of only 16.2 months (p <.001). Besides albumin, bilirubin, tumor number, and tumor diameter, BMD remained an independent prognostic factor in multivariate analysis. Conclusions: BMD is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. The integration of BMD into novel scoring systems could potentially improve survival prediction and clinical decision-making. Key Points: • Bone mineral density can be easily assessed in routinely acquired pre-interventional computed tomography scans. • Bone mineral density is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. • Thus, bone mineral density is a novel imaging biomarker for prognosis prediction in elderly patients with HCC undergoing TACE.
AB - Objectives: Low bone mineral density (BMD) was recently identified as a novel risk factor for patients with hepatocellular carcinoma (HCC). In this multicenter study, we aimed to validate the role of BMD as a prognostic factor for patients with HCC undergoing transarterial chemoembolization (TACE). Methods: This retrospective multicenter trial included 908 treatment-naïve patients with HCC who were undergoing TACE as a first-line treatment, at six tertiary care centers, between 2010 and 2020. BMD was assessed by measuring the mean Hounsfield units (HUs) in the midvertebral core of the 11th thoracic vertebra, on contrast-enhanced computer tomography performed before treatment. We assessed the influence of BMD on median overall survival (OS) and performed multivariate analysis including established estimates for survival. Results: The median BMD was 145 HU (IQR, 115–175 HU). Patients with a high BMD (≥ 114 HU) had a median OS of 22.2 months, while patients with a low BMD (< 114 HU) had a lower median OS of only 16.2 months (p <.001). Besides albumin, bilirubin, tumor number, and tumor diameter, BMD remained an independent prognostic factor in multivariate analysis. Conclusions: BMD is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. The integration of BMD into novel scoring systems could potentially improve survival prediction and clinical decision-making. Key Points: • Bone mineral density can be easily assessed in routinely acquired pre-interventional computed tomography scans. • Bone mineral density is an independent predictive factor for survival in elderly patients with HCC undergoing TACE. • Thus, bone mineral density is a novel imaging biomarker for prognosis prediction in elderly patients with HCC undergoing TACE.
UR - http://www.scopus.com/inward/record.url?scp=85136583230&partnerID=8YFLogxK
U2 - 10.1007/s00330-022-09069-8
DO - 10.1007/s00330-022-09069-8
M3 - Journal articles
C2 - 35986768
AN - SCOPUS:85136583230
SN - 0938-7994
VL - 33
SP - 1031
EP - 1039
JO - European Radiology
JF - European Radiology
IS - 2
ER -