Preoperative prediction of early recurrence of HBV-related hepatocellular carcinoma (≤5 cm) by visceral adipose tissue index

Zong-Qian Wu; Jie Cheng; Xi-Xi Xiao; Hua-Rong Zhang; Jian Wang; Juan Peng; Chen Liu; Ping Cai; Xiao-Ming Li

doi:10.3389/fsurg.2022.985168

Preoperative prediction of early recurrence of HBV-related hepatocellular carcinoma (≤5 cm) by visceral adipose tissue index

Front Surg. 2023 Jan 6:9:985168. doi: 10.3389/fsurg.2022.985168. eCollection 2022.

Authors

Zong-Qian Wu¹, Jie Cheng¹, Xi-Xi Xiao², Hua-Rong Zhang³, Jian Wang¹, Juan Peng⁴, Chen Liu¹, Ping Cai¹, Xiao-Ming Li¹

Affiliations

¹ Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
² Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
³ Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
⁴ Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Abstract

Background: This study aimed to investigate whether visceral adipose tissue index (VATI) is a significant risk factor for the early recurrence (ER) of HBV-related hepatocellular carcinoma (HCC) (≤5 cm) after hepatectomy.

Methods: The recruited cohort patients who were positive for hepatitis B virus, presented with surgically confirmed HCC (≤5 cm) from Army Medical University (internal training cohort: n = 192) and Chongqing Medical University (external validation group: n = 46). We measured VATI, subcutaneous adipose tissue index (SATI) via computed tomography (CT). ER was defined as recurrence within 2 years after hepatectomy. The impact of parameters on outcome after hepatectomy for HCC was analyzed.

Results: Univariate analysis showed that alpha-fetoprotein levels (p = 0.044), body mass index (BMI) (p < 0.001), SATI (p < 0.001), and VATI (p < 0.001) were significantly different between ER and non-ER groups in internal training cohort. Multivariate analysis identified VATI as an independent risk factor for ER (odds ratio = 1.07, 95% confidence interval: 1.047-1.094, p < 0.001), with a AUC of 0.802, based on the cut-off value of VATI, which was divided into high risk (≥37.45 cm²/m²) and low risk (<37.45 cm²/m²) groups. The prognosis of low risk group was significantly higher than that of high risk group (p < 0.001). The AUC value of VATI in external validation group was 0.854.

Conclusion: VATI was an independent risk factor for the ER, and higher VATI was closely related to poor outcomes after hepatectomy for HBV-related HCC (≤5 cm).

Keywords: HBV; HCC; abdominal adipose tissue; computed tomography; early recurrence; visceral adipose tissue.