title: Sarcopenia is a risk factor for the recurrence of hepatocellular carcinoma after curative treatment.
abstract: OBJECTIVE
  Sarcopenia, initially proposed as decreased of muscle mass and strength, is associated with aging and malignant diseases. The aim of the present study was to determine whether there is a correlation between sarcopenia and the recurrence of hepatocellular carcinoma (HCC) after curative treatment.
  
  
  METHODS
  We conducted a retrospective analysis of consecutive naive patients with HCC who underwent curative resection or radiofrequency ablation. To eliminate the influence of cause or the severity of liver damage, subjects were limited to those with HCC with hepatitis C-related cirrhosis and Child-Pugh class A liver function. Patients were assessed using computed tomographic measurement of muscle mass at the level of the third lumbar (L3) vertebrae, the L3 skeletal muscle index (L3 SMI). Sarcopenia was defined by using previously published, sex-specific cut-off value.
  
  
  RESULTS
  Sarcopenia was present in 61 of 92 patients. Patients' median age was 71.5 years (range, 47-84), and the baseline characteristics of patients were comparable between patients with and without sarcopenia except for sex, serum albumin level, prothrombin time, diabetes mellitus and body mass index. Recurrence rates at 1, 3 and 5 years were 39.1%,77.1%,81.7% for patients with sarcopenia and 23.5%,59.5% and 75.7% for patients without sarcopenia, respectively (P = 0.03). Multivariate Cox analysis revealed that sarcopenia and preoperative α-fetoprotein of more than 40 ng/mL were significant independent factors for recurrence.
  
  
  CONCLUSIONS
  Sarcopenia is a risk factor for recurrence in patients with HCC who were treated with curative treatment.
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Saori
authors.initials: S
authors.lastname: Kamachi
authors.affiliation: Department of Internal Medicine, Imari Arita Kyoritsu Hospital, Saga, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Taiga
authors.initials: T
authors.lastname: Otsuka
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Shunya
authors.initials: S
authors.lastname: Nakashita
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ide
authors.affiliation: Department of Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyoshi
authors.affiliation: Department of Surgery, Saga-Ken Medical Centre Koseikan, Saga, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kitahara
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
authors.affiliation: Department of Internal Medicine, Division of Hepatology, Diabetes, Metabolism and Endocrinology, Saga University, Saga, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Anzai
keywords: prognostic factor; radiofrequency ablation; skeletal muscle; surgical resection; third lumbar skeletal muscle index