DOI: 10.1111/hepr.13959 ISSN:

Significance of malnutrition defined with GLIM criteria in patients with hepatocellular carcinoma after hepatic resection

Norifumi Harimoto, Mariko Tsukagoshi, Takayuki Okuyama, Kouki Hoshino, Kei Hagiwara, Shunsuke Kawai, Norihiro Ishii, Takamichi Igarashi, Kenichiro Araki, Ken Shirabe
  • Infectious Diseases
  • Hepatology

Abstract

Aim

A recent study reported the utility of the malnutrition defined the Global Leadership Initiative on Malnutrition (GLIM) criteria in many types of cancers and chronic inflammatory disease. The present retrospective study aimed to investigate the significance of the malnutrition defined with GLIM criteria in patients with hepatic resection for hepatocellular carcinoma (HCC) and also to compare the malnutrition using hand grip strength.

Methods

We retrospectively reviewed data from 174 patients who had undergone curative hepatic resection for HCC including both skeletal muscle area and hand grip strength. Patients were divided to malnutrition defined by GLIM or modified GLIM and clinicopathological and short‐ and long‐term outcomes were analyzed. The modified GLIM criteria was defined using both hand grip strength and skeletal muscle area.

Results

The malnutrition defined by GLIM criteria were 47 patients (26.7%) and malnutrition defined by modified GLIM criteria were 21 patients (11.9%). The malnutrition defined by GLIM or modified GLIM criteria were both associated with poorer liver function and malignant tumor behavior, but modified GLIM criteria predicted the postoperative complication and recurrence‐free survival outcome independently. In patients with poor liver function, malnutrition defined by modified GLIM criteria predicted postoperative complication and overall and recurrence‐free survival.

Conclusions

The malnutrition defined by modified GLIM criteria using both hand grip strength and skeletal muscle area can predict more accurately the short‐term and long‐term outcome compared to malnutrition defined by the GLIM criteria. Nutritional and exercise therapy may become more important in patients with malnutrition and poor liver function.

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