## 3 Results
### Predictive Factors Associated with OS  
Factors assessed in the univariate analysis were age (<72 years /\(\geqslant\)72 years), sex (male/female), Child-Pugh classification (A/B), mALBI grade (1-2a/2b-3), BCLC stage (A-B/C), muscle depletion (presence/absence), low handgrip strength (presence/absence), and sarcopenia (presence/absence). Of these factors, mALBI grade (\(p\) = 0.018), BCLC stage (\(p\) = 0.007), low handgrip strength (\(p\) = 0.010), and sarcopenia (\(p\) = 0.050) were significant factors, but muscle depletion was not significant (Table 2A).  
Figure 2: Comparison of overall survival according to the evaluation of handgrip strength, skeletal muscle, or sarcopenia. (**A**) Patients with low handgrip strength showed significantly shorter survival than those with high handgrip strength (MST: low handgrip strength group, 10.2 months; high handgrip strength group, 24.0 months; \(p\) = 0.010). (**B**) No significant difference was found between patients with and without muscle depletion (\(p\) = 0.675). (**C**) Patients with sarcopenia showed significantly shorter survival than those without sarcopenia (MST: sarcopenia group, 8.4 months; non-sarcopenia group, 24.0 months; \(p\) = 0.035).  
\begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline  & \multicolumn{2}{c}{**Univariate Analysis (A)**} & \multicolumn{3}{c}{**Multivariate Analysis (B)**} & \multicolumn{3}{c}{**Multivariate Analysis (C)**} \\ \hline  & Hazard ratio & 95\% CI & \(p\)-value & Hazard ratio & 95\% CI & \(p\)-value & Hazard ratio & 95\% CI & \(p\)-value \\ Age \(<\)7/2\(>\)72 & 1.580 & 0.634-4.256 & 0.330 & & & & & \\ Sex Index/Female & 1.203 & 0.388-3.152 & 0.728 & & & & & \\ Child-Pugh class A/B & 1.586 & 0.512-4.151 & 0.395 & & & & & \\ mALBI grade 1–2a/2b–3 & 3.724 & 1.233-16.064 & 0.018 & 4.209 & 1.370-18.362 & 0.010 & 5.247 & 1.607–24.201 & 0.004 \\ BCLC A –B/C & 3.715 & 1.420-11.501 & 0.007 & 3.480 & 1.320–10.833 & 0.011 & 3.258 & 1.229–10.179 & 0.017 \\ Muscle depletion \(-\)/+ & 1.214 & 0.487-3.072 & 0.675 & & & & & \\ Low bandgap strength \(-\)/+ & 3.518 & 1.343–10.904 & 0.010 & 3.313 & 1.257–10.314 & 0.015 & & \\ Sarocepnia \(-\)/+ & 2.621 & 0.999-6.592 & 0.050 & & & 3.256 & 1.136–9.478 & 0.029 \\ \hline \end{tabular}
\end{table}
Table 2: Univariate and multivariate analyses of factors associated with overall survival.  
As having low handgrip strength was considered in the diagnosis of sarcopenia, multivariate analysis was performed separately using either of the two factors (low handgrip strength and sarcopenia). The first multivariate analysis, which was performed using factors found to be significant (\(p\)-value \(\leq\) 0.1; mALBI grade, BCLC stage, and low handgrip strength), revealed the following three factors as significant: mALBI grade 2b-3 (HR, 4.209; 95% CI, 1.370-18.362; \(p\) = 0.010), BCLC stage C (HR, 3.480; 95% CI, 1.320-10.833; \(p\) = 0.011), and the presence of low handgrip strength (HR, 3.313; 95% CI, 1.257-10.314; \(p\) = 0.015; Table 2B). Then, the second multivariate analysis of significant factors (\(p\)-value \(\leq\) 0.1; mALBI grade, BCLC stage, and sarcopenia) revealed these three factors as significant: mALBI grade 2b-3 (HR, 5.247; 95% CI, 1.607-24.201; \(p\) = 0.004), BCLC stage C (HR, 3.258; 95% CI, 1.229-10.179; \(p\) = 0.017), and the presence of sarcopenia (HR, 3.256; 95% CI, 1.136-9.478; \(p\) = 0.029; Table 2C).