ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
This article is part of the Research TopicImmunology and Therapeutic Innovations in Hepatocellular Carcinoma: Exploring Immune Evasion and BeyondView all 17 articles
Prognostic Significance of Reduced Handgrip Strength in Patients with Unresectable Hepatocellular Carcinoma Receiving HAIC Combined with Targeted Immunotherapy
Provisionally accepted
- 1Department of Hand Surgery, Wuhan Fourth Hospital, Wuhan, China
- 2Department of Hepatobiliary-Pancreatic and Hernia Surgery, Wuhan Fourth Hospital, Wuhan, China
- 3Hepatic Surgery Center, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, China
- 4Research Laboratory and Hepatic Surgery Center, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Wuhan, China
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Abstract Word count: 241 Background: Hepatic arterial infusion chemotherapy (HAIC) combined with targeted immunotherapy has emerged as a key therapeutic option for advanced (or unresectable ) hepatocellular carcinoma (HCC). Nevertheless, treatment efficacy varies significantly among individuals. Sarcopenia, characterized by loss of muscle mass and strength, may adversely affect therapeutic outcomes and patient prognosis. This study investigates the clinical relevance of sarcopenia in patients undergoing HAIC combined with targeted immunotherapy.Methodsâ…ˇA total of 265 patients with unresectable HCC who received HAIC combined with targeted immunotherapy were retrospectively enrolled in this study, and divided into two groups (sarcopenic and non-sarcopenic group). Sarcopenia was defined based on handgrip strength (HGS), with a cutoff value of less than 28kg(male) and 18kg(female). Overall survival (OS) and progression-free survival (PFS) were compared between groups using the log-rank test and multivariate Cox proportional hazards models. Additionally, propensity score matching (PSM) was applied to minimize baseline differences and enhance comparability. Then, differences in treatment response, survival outcomes, and adverse events between the sarcopenic and non-sarcopenic groups were evaluated using appropriate statistical analyses.Results: Patients in sarcopenia group exhibited significantly poorer OS and PFS compared to those with non-sarcopenic group. Sarcopenia was also associated with lower objective response rates.Multivariate analysis confirmed that sarcopenia was an independent prognostic factor for poor outcomes.Sarcopenia is a significant predictor of poor prognosis in patients with unresectable HCC treated with HAIC combined with targeted immunotherapy. Incorporating HGS assessment into clinical practice may help optimize individualized treatment strategies and enhance patient management.
Keywords: handgrip strength, Sarcopenia, Hepatocellular Carcinoma, HAIC, Targeted immunotherapy, prognosis
Received: 24 Jul 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Wang, Wang, Lv, Liang, Zhang, Zhang and Ji. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Erlei Zhang
Guibao Ji
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