Effect of body composition on outcomes after hepatic resection for hepatocellular carcinoma

Ann Surg Oncol. 2014 Sep;21(9):3063-8. doi: 10.1245/s10434-014-3686-6. Epub 2014 Apr 10.

Abstract

Purpose: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Composition*
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Follow-Up Studies
  • Hepatectomy / adverse effects*
  • Humans
  • Incidence
  • Intra-Abdominal Fat / pathology*
  • Japan / epidemiology
  • Liver Neoplasms / complications
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / diagnosis
  • Neoplasm Recurrence, Local / etiology*
  • Neoplasm Staging
  • Postoperative Complications / diagnosis
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Tomography, X-Ray Computed