title: Sarcopenia as a predictor of prognosis in patients following hepatectomy for hepatocellular carcinoma.
abstract: BACKGROUND
  Sarcopenia was identified recently as a poor prognostic factor in patients with cancer. The present study investigated the effect of sarcopenia on short- and long-term outcomes following partial hepatectomy for hepatocellular carcinoma (HCC), and aimed to identify prognostic factors.
  
  
  METHODS
  Data were collected retrospectively for all consecutive patients who underwent hepatectomy for HCC with curative intent between January 2004 and December 2009. Patients were assigned to one of two groups according to the presence or absence of sarcopenia, assessed by computed tomographic measurement of muscle mass at the level of the third lumbar vertebra. Clinicopathological, surgical outcome and long-term survival data were analysed.
  
  
  RESULTS
  Sarcopenia was present in 75 (40·3 per cent) of 186 patients, and was significantly correlated with female sex, lower body mass index and liver dysfunction, as indicated by abnormal serum albumin levels and indocyanine green retention test at 15 min values. In patients with, and without sarcopenia, the 5-year overall survival rate was 71 and 83·7 per cent respectively, and the 5-year recurrence-free survival rate was 13 and 33·2 per cent respectively. Multivariable analysis revealed that reduced skeletal muscle mass was predictive of an unfavourable prognosis.
  
  
  CONCLUSIONS
  Sarcopenia was predictive of worse overall survival even when adjusted for other known predictors in patients with HCC after partial hepatectomy.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Harimoto
authors.forename: K
authors.initials: K
authors.lastname: Shirabe
authors.forename: Y-I
authors.initials: YI
authors.lastname: Yamashita
authors.forename: T
authors.initials: T
authors.lastname: Ikegami
authors.forename: T
authors.initials: T
authors.lastname: Yoshizumi
authors.forename: Y
authors.initials: Y
authors.lastname: Soejima
authors.forename: T
authors.initials: T
authors.lastname: Ikeda
authors.forename: Y
authors.initials: Y
authors.lastname: Maehara
authors.forename: A
authors.initials: A
authors.lastname: Nishie
authors.forename: T
authors.initials: T
authors.lastname: Yamanaka
mesh_terms: D000368:Aged; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology*; D012189:Retrospective Studies; D055948:Sarcopenia / Q000150:complications*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome