Table 1.
Clinical background of patients treated with lenvatinib.
Fig 1.
Association of each body composition measure with overall survival (OS).
(a) Total skeletal muscle mass index (SMI), (b) arm SMI, (c) leg SMI, and (d) extracellular water to total body water ratio (ECW/TBW). The cutoff for SMI was 7.0 kg/m2 for males and 5.7 kg/m2 for females, which aligns with the diagnostic criteria of the Japanese Society of Hepatology. The cutoff for arm SMI and leg SMI was the median value. The cutoff for ECW/TBW was 0.400, as previously reported. (d) For the ECW/TBW, patients with an ECW/TBW of ≤ 0.400 experienced significantly longer OS than those with an ECW/TBW of > 0.400 (19.2 months vs 11.9 months, P < 0.001). (a—c) Total SMI, arm SMI, and leg SMI were not associated with OS (total SMI, 17.2 months vs 19.3 months, P = 0.265; arm SMI, 17.2 months vs 21.2 months, P = 0.115; leg SMI, 18.0 months vs 18.9 months, P = 0.496).
Fig 2.
Association of each body composition measure with progression-free survival (PFS).
(a) Total skeletal muscle mass index (SMI), (b) arm SMI, (c) leg SMI, and (d) extracellular water to total body water ratio (ECW/TBW). The cutoff for SMI was 7.0 kg/m2 for males and 5.7 kg/m2 for females, which aligns with the diagnostic criteria of the Japanese Society of Hepatology. The cutoff for arm SMI and leg SMI was the median value. (d) For ECW/TBW, patients with an ECW/TBW of ≤ 0.400 experienced a significantly longer PFS than those with an ECW/TBW of > 0.400 (8.9 months vs 4.6 months, P = 0.007). (b) For arm SMI, patients with a value above the median arm SMI experienced a significantly longer PFS than those with a value under the median arm SMI (11.9 months vs 6.7 months, P = 0.029). (a, c) Total SMI and leg SMI were not associated with PFS (SMI, 8.3 months vs 8.7 months, P = 0.273; leg SMI, 7.0 months vs 8.3 months, P = 0.557).
Fig 3.
Association of each body composition measure with post-progression survival (PPS).
(a) Total skeletal muscle mass index (SMI), (b) arm SMI, (c) leg SMI, and (d) extracellular water to total body water ratio (ECW/TBW). The cutoff for SMI was 7.0 kg/m2 for males and 5.7 kg/m2 for females, which aligns with the diagnostic criteria of the Japanese Society of Hepatology. The cutoff for arm SMI and leg SMI was the median value. (d) For ECW/TBW, patients with an ECW/TBW of ≤ 0.400 experienced a significantly longer PPS than those with an ECW/TBW of > 0.400 (10.9 months vs 4.5 months, P < 0.001). (a—c) Total SMI, arm SMI, and leg SMI were not associated with PPS (total SMI, 8.6 months vs 9.7 months, P = 0.593; arm SMI, 8.2 months vs 8.6 months, P = 0.556; leg SMI, 9.3 months vs 8.6 months, P = 0.757).
Table 2.
Factors associated with overall survival treated with lenvatinib.
Table 3.
Factors associated with progression free survival treated with lenvatinib.
Table 4.
Factors associated with post progression survival treated with lenvatinib.
Fig 4.
Scatter plots and approximate lines of changes in body composition and duration.
(a) Total skeletal muscle mass index (SMI), (b) arm SMI, (c) leg SMI, (d) extracellular water to total body water ratio (ECW/TBW), and (e) body fat percentage. There was no correlation between the follow-up duration and the amount of change in body composition. The horizontal axis shows the time from the start of lenvatinib treatment to the day of the second body composition measurement, and the dots show the percentage change in body composition. (b) The arm SMI decreased in many cases and (d) the ECW/TBW increased in many cases.
Fig 5.
Correlation between the rate of change in ECW/TBW and that for each SMI measure.
(a) Total SMI, (b) arm SMI, and (c) leg SMI. (b) The ECW/TBW and arm SMI were not correlated with the rate of change (r = −0.155, P = 0.167). (a) The rate of change of the ECW/TBW and total SMI and (c) that of ECW/TBW and leg SMI were positively correlated (r = 0.492, P < 0.001 and r = 0.571, P < 0.001).
Fig 6.
Association between the rate of change in body composition and prognosis.
The group with ECW/TBW ≤ 0.400 before lenvatinib treatment with a rate of change in the arm skeletal muscle mass index (SMI) above the median had a significantly longer (a) overall survival (OS) (data not available vs 18.0 months, P = 0.0117) and (b) progression-free survival (PFS) (12.3 months vs 6.9 months, P = 0.043) than the group with a rate of change in the arm SMI below the median.
Fig 7.
Association of extracellular water to total body water ratio with the duration of first dose reduction or drug withdrawal.
The cutoff for extracellular water to total body water ratio (ECW/TBW) was 0.400, as previously reported. Patients with an ECW/TBW of > 0.400 experienced significantly shorter duration of first dose reduction or drug withdrawal than those with an ECW/TBW of ≤ 0.400 (0.4 months vs 2.0 months, P < 0.001).