title: Effect of Intramuscular Adipose Tissue Content on Prognosis in Patients Undergoing Hepatocellular Carcinoma Resection.
abstract: BACKGROUND
  It has recently been reported that myosteatosis, the infiltration of fat in skeletal muscle, is associated with insulin resistance and type 2 diabetes mellitus. The present study investigated the effect of skeletal muscle fat accumulation on short- and long-term outcomes following partial hepatectomy for hepatocellular carcinoma (HCC) and aimed to identify prognostic factors.
  
  
  METHODS
  The records of 141 HCC patients who underwent hepatectomy were retrospectively reviewed. Clinicopathological and outcome data from 71 patients with high intramuscular adipose tissue content (IMAC) were compared with those from 70 patients with low IMAC.
  
  
  RESULTS
  The 5-year overall survival rate was 46% among patients with high IMAC and 75% among those with low IMAC. The 5-year disease-free survival rates in these groups were 18 and 38%, respectively. Multivariate analysis revealed that high IMAC was predictive of an unfavorable prognosis. High IMAC was significantly correlated with liver dysfunction, higher intraoperative blood loss, the need for blood transfusion, and comorbid diabetes mellitus.
  
  
  CONCLUSIONS
  Greater fat accumulation in skeletal muscle was predictive of worse overall survival after partial hepatectomy in patients with HCC, even with adjustment for other known predictors. The identification of patients with greater skeletal muscle fat accumulation before hepatectomy could permit early preventive strategies to maintain muscle quality and thus improve prognosis and patient selection for hepatectomy.
authors.affiliation: Department of Surgery, Hirakata Hospital, Kansai Medical University, 2-5-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan, kaibori@hirakata.kmu.ac.jp.
authors.forename: Masaki
authors.initials: M
authors.lastname: Kaibori
authors.forename: Morihiko
authors.initials: M
authors.lastname: Ishizaki
authors.forename: Hiroya
authors.initials: H
authors.lastname: Iida
authors.forename: Kosuke
authors.initials: K
authors.lastname: Matsui
authors.forename: Tatsuma
authors.initials: T
authors.lastname: Sakaguchi
authors.forename: Kentaro
authors.initials: K
authors.lastname: Inoue
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ide
authors.forename: Junji
authors.initials: J
authors.lastname: Iwasaka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Hayashi
authors.forename: Daiki
authors.initials: D
authors.lastname: Habu
authors.forename: Masanori
authors.initials: M
authors.lastname: Kon
mesh_terms: D000273:Adipose Tissue / Q000473:pathology*; D000368:Aged; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008113:Liver Neoplasms / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology*; D012189:Retrospective Studies; D015996:Survival Rate