الفهرس 
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Abstract
This study was conducted to determine the prognostic value of sarcopenia as a predictive method for survival of patients with hepatocellular carcinoma (HCC) who received curative treatment.
One hundred patients were selected in this study, at Tropical Medicine department and HCC clinic, Ain Shams University Hospitals. All patients have undergone RAF for HCC between April 2018 and December 2018. According to presence or absence of sarcopenia, the enrolled patients were divided into 2 groups (sarcopenic and non sarcopenic).
All patients were monitored after the procedure by AFP and triphasic spiral CT performed 1 month after curative treatment to evaluate the response and then every 3 months for at least 7 months to evaluate the recurrence. Overall survival and disease free survival were evaluated in sarcopenic and non sarcopenic patients.
Illegible patients were evaluated by history, clinical examination, laboratory investigations including (CBC , KFTs , LFTs, INR and alpha feto protein) and imaging including (pelvi-abdominal ultrasound and triphasic CT scan).
Etiology of liver cirrhosis and child score was determined and presence or absence of DM was involved.
Sarcopenia is determined by using Triphasic CT and specific software that enabled us to measure the muscle area at the level of third lumbar vertebra.
The results of this study showed that sarcopenic patients had significantly lower BMI and higher prevalence of DM than non sarcopenic patients. Patients with sarcopenia at baseline had significant worse overall survival and disease free survival after RFA for early/very early HCC when compared to patients with no sarcopenia. Presence of sarcopenia and higher MELD Na score at base line were independent risk factors and significantly associated with poor overall survival after RFA on multivariate analysis moreover, only baseline sarcopenia was significantly associated with recurrence after RFA using cox regression analysis
In conclusion, sarcopenia may be a strong predictor for poor outcome after RFA for early and very early HCC.