title: Obesity conveys poor outcome in patients with hepatocellular carcinoma treated by transarterial chemoembolization.
abstract: OBJECTIVE
  The purpose of this retrospective study was to evaluate the impact of obesity on radiologic outcomes in patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE).
  
  
  METHODS
  A total of 100 TACE procedures performed in 57 patients (42 men, 15 women) with a mean age of 62 years±8.4 (SD) (range: 39-83 years) were retrospectively reviewed. The 1-2-month follow-up computed tomography or magnetic resonance imaging examinations was assessed for new or residual disease and radiologic response using mRECIST criteria. Patients were categorized into two groups according to body mass index (BMI). Patients with BMI<25kg/m2were further referred as to low BMI patients and those with BMI≥25kg/m2as high BMI patients. Outcomes were compared between the two groups.
  
  
  RESULTS
  Low and high BMI patients were similar in regard to age, gender, HCC etiology and stage, and pre-procedure disease burden. TACE for high BMI, compared to low BMI, patients resulted in lower complete response (39% vs. 66%) and higher progressive disease (21% vs. 5%) rates (P=0.04), and higher rates of residual disease (63% vs. 39%, P=0.02) and new lesions in untreated liver (39% vs. 18%, P=0.04) on 1-2-month follow-up imaging.
  
  
  CONCLUSIONS
  High BMI is associated with significantly more residual disease, new lesions, and progressive disease in patients with HCC treated by TACE.
authors.affiliation: Vascular and Interventional Radiology, NYU Langone Medical Center, 560 1st Avenue, 2nd Floor, New York, NY 10016, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Wu
authors.affiliation: Vascular and Interventional Radiology, NYU Langone Medical Center, 560 1st Avenue, 2nd Floor, New York, NY 10016, USA.
authors.forename: H W
authors.initials: HW
authors.lastname: Charles
authors.affiliation: Division of Gastroenterology, Department of Medicine, NYU Langone Medical Center, 550 1st avenue, New York, NY 10016, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Park
authors.affiliation: Hematology, Department of Medicine, NYU Langone Medical Center, 157 East 32nd Street, 2nd Floor, New York, NY 10016, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Goldenberg
authors.affiliation: Vascular and Interventional Radiology, NYU Langone Medical Center, 560 1st Avenue, 2nd Floor, New York, NY 10016, USA. Electronic address: adeipolyi@yahoo.com.
authors.forename: A R
authors.initials: AR
authors.lastname: Deipolyi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging; D018365:Neoplasm, Residual / Q000000981:diagnostic imaging; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies
keywords: Cancer treatment; Hepatocellular carcinoma; Obesity; Outcome; Transarterial chemoembolization