Effects of In-Hospital Exercise on Sarcopenia in Hepatoma Patients Who Underwent Transcatheter Arterial Chemoembolization.

BACKGROUND AND AIMS: Sarcopenia is a prognostic factor in hepatocellular carcinoma (HCC) patients. HCC patients who underwent transcatheter arterial chemoembolization (TACE) are at a risk of muscle atrophy. We aimed to investigate the effects of in-hospital exercise on muscle mass and factors associated with muscle hypertrophy in HCC patients who underwent TACE.

METHODS: We enrolled 209 HCC patients who underwent TACE. Patients were classified into either an Exercise (n=102) or Control (n=107) group. In the Exercise group, patients were treated with in-hospital exercise (median 2.5 metabolic equivalents/20-40 min/day). The effects of exercise on muscle mass were evaluated by changes in skeletal muscle index (ΔSMI) between before and after TACE. Factors associated with an increase in SMI were analyzed by logistic regression and decision-tree analyses.

RESULTS: There was no significant difference in serum albumin and bilirubin levels between the two groups. ΔSMI was significantly higher in the Exercise group than in the Control group (0.28 cm2 /m2 vs. -1.11 cm2 /m2 , P=0.0029). In the logistic regression analysis, exercise was an independent factor for an increase in SMI (HR 2.13; 95% CI 1.215-3.846; P=0.0085). Moreover, the decision-tree analysis showed that exercise was the initial divergence variable for an increase in SMI (the ratio of increased SMI: 53% in the exercise group vs. 36% in the Control group).

CONCLUSIONS: In-hospital exercises increased muscle mass in HCC patients who underwent TACE. In addition, exercise was an independent factor for muscle hypertrophy. Thus, in-hospital exercise may prevent sarcopenia in HCC patients who underwent TACE.