Effect of body composition on outcomes after hepatic resection for hepatocellular carcinoma.
OBJECTIVE
To evaluate the effect of body composition on outcomes after hepatic resection for patients with hepatocellular carcinoma (HCC).


METHODS
We performed 190 hepatic resections for HCC and divided the patients into 2 groups on the basis of visceral fat area (VFA), assessed by computed tomographic measurement at the level of the umbilicus, into high VFA (H-VFA) (n = 106) and low VFA (L-VFA) (n = 84) groups. We compared the surgical outcomes between the two groups.


RESULTS
L-VFA was significantly correlated with a lower body mass index, sarcopenia, lower serum albumin, and liver cirrhosis. There was no difference in the incidence of postoperative complications and mortality between the 2 groups. Patients in the L-VFA group had a significantly poorer prognosis than those in the H-VFA group in terms of both overall (P = 0.043) and recurrence-free (P = 0.001) survival. The results of multivariate analysis showed that sarcopenia rather than L-VFA was an independent and prognostic indicator after hepatic resection with HCC.


CONCLUSIONS
Body composition is an important factor affecting cancer outcomes after hepatic resection for HCC in Japan.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan, itoshin@surg2.med.kyushu-u.ac.jp.
Shinji
S
Itoh
Ken
K
Shirabe
Yoshihiro
Y
Matsumoto
Shohei
S
Yoshiya
Jun
J
Muto
Norifumi
N
Harimoto
Yo-Ichi
Y
Yamashita
Toru
T
Ikegami
Tomoharu
T
Yoshizumi
Akihiro
A
Nishie
Yoshihiko
Y
Maehara
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D050152:Intra-Abdominal Fat / Q000473:pathology*; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed