Evidence map›Paper›PMID 40675925›Full record

ArticleGut and liver2025

Dynamic Muscle Atrophy Predicts Outcomes in Patients with Unresectable Hepatocellular Carcinoma Treated with First-Line Lenvatinib: A Retrospective Study in Taiwan.

Hsing-Yun Lee, Ching-Di Chang, Yen-Hao Chen, Ming-Chao Tsai, Jing-Houng Wang, Sheng-Nan Lu, Tsung-Hui Hu, Chao-Hung Hung, Chien-Hung Chen, Yuan-Hung Kuo

Abstract read
In one paragraph

Article in Gut and liver, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hsing-Yun LeeDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Ching-Di ChangDivision of Radiology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0001-6683-0013
Yen-Hao ChenDivision of Oncology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-5622-5490
Ming-Chao TsaiDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-3613-2051
Jing-Houng WangDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-4916-9814
Sheng-Nan LuDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-5493-4752
Tsung-Hui HuDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-9172-1967
Chao-Hung HungDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0003-1646-9519
Chien-Hung ChenDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0002-8896-8133
Yuan-Hung KuoDivision of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.ORCID 0000-0003-0185-1846

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background/Aims: Muscle volume loss (MVL) is associated with poor outcomes in patients with hepatocellular carcinoma (HCC). However, dynamic muscle atrophy during HCC treatment is also a critical concern. This study aimed to determine the clinical significance of MVL and severe muscle atrophy following lenvatinib treatment among patients with unresectable HCC. Methods: This study included 302 patients with unresectable HCC who received first-line lenvatinib between July 2019 and December 2022. MVL was defined using the psoas muscle index, while severe muscle atrophy was classified as a ≥1.5% decrease in the psoas muscle index per month after lenvatinib initiation. To reduce the risk of selection bias, propensity score matching was performed. Results: After propensity score matching, 168 patients were included, comprising 112 non-MVL and 56 MVL patients. The MVL group had significantly worse overall survival (9.9 months vs 15.0 months, p=0.021) and a higher incidence of treatment-related adverse events (82.8% vs 66.6%, p=0.03) than the non-MVL group. Among 128 patients with dynamic imaging assessments, those with severe muscle atrophy (n=76) had significantly shorter progression-free survival (4.1 months vs 10.9 months, p<0.001) and overall survival (11.1 months vs 25.9 months, p<0.001) than patients with mild atrophy. Multivariate analysis revealed that severe muscle atrophy was an independent risk factor for progression-free survival (hazard ratio [HR], 2.388; 95% confidence interval [CI], 1.519 to 3.756; p<0.001) and overall survival (HR, 2.130; 95% CI, 1.152 to 3.939; p=0.016), while MVL was not. Conclusions: In real-world clinical practice, severe muscle atrophy is a stronger prognostic indicator than MVL among patients with unresectable HCC treated with first-line lenvatinib.

Indexed as

Antineoplastic AgentsCarcinoma, HepatocellularLiver NeoplasmsMuscular AtrophyPhenylurea CompoundsQuinolinesAgedFemaleHumansMaleMiddle AgedPrognosisPropensity ScorePsoas MusclesRetrospective StudiesTaiwanAntineoplastic AgentslenvatinibPhenylurea CompoundsQuinolinesCarcinoma, hepatocellularLenvatinibMuscle atrophyPsoas musclesSarcopenia

Identifiers

PMID40675925
PMCPMC12616142

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.