{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:25:31Z","timestamp":1787034331205,"version":"build-2736575974"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:00:00Z","timestamp":1787011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Patients with hepatocellular carcinoma (HCC) and a high tumor burden, such as those presenting with a tumor diameter of \u2265 10\u00a0cm or\/and major portal vein tumor thrombosis (PVTT), generally face a poor prognosis. Sarcopenia is common in this population. Triple therapy combining hepatic arterial infusion chemotherapy (HAIC), lenvatinib, and programmed death receptor-1 (PD-1) inhibitors has shown encouraging outcomes in these patients. This study investigated the association between sarcopenia and the prognosis in patients with high tumor burden HCC patients receiving this triple therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 449 patients with high tumor burden HCC patients who received HAIC-LEN-PD1 triple therapy of from January 2022 to December 2024. Sarcopenia was assessed using the skeletal muscle index (SMI). Propensity score matching (PSM) was used to balance baseline characteristics between groups. Treatment efficacy was evaluated by overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Cox proportional hazards regression analyses were performed to identify independent factors associated with OS and PFS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Totally 449 patients were analyzed, including 131 in the sarcopenia group and 318 in the non-sarcopenia group. After PSM(1:1), 131 patients were matched in each group. Median OS was 12.2 months in the sarcopenia group and 18.1 months in the non-sarcopenia group(hazard ratio [HR]: 1.84;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). PFS was also shorter among patients with sarcopenia, with a median of 6.9 months compared with 9.9 months among those without sarcopenia (HR: 1.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). ECOG PS, and sarcopenia were independent predictors for OS and PFS (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sarcopenia was associated with an poor prognosis in patients with high tumor burden HCC patients who received HAIC-LEN-PD1 therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1782185","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:38:18Z","timestamp":1787031498000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between sarcopenia and the prognosis of patients with high tumor burden hepatocellular carcinoma receiving hepatic artery infusion chemotherapy combined with lenvatinib and programmed death receptor-1 inhibitor: a multicenter, propensity score matching comparative study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xinge","family":"Li","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunlong","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Tianjin Baodi Hospital, Baodi Hospital Affiliated to Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Interventional Therapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]},{"name":"Department of Interventional Therapy, The First Affiliated Hospital with Nanjing Medical University","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Interventional Treatment, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin\u2019s Clinical Research Center for Cancer","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengfei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]},{"name":"Department of General Surgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Interventional Therapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunxue","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Interventional Therapy, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianzhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences","place":["Jinan, Shandong, 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