Impact of body mass index on hepatocellular carcinoma recurrence after liver transplantation through long-term follow-up

Abstract

Background: Obesity is associated with increased oncological risk and outcomes but the evidence surrounding the effect of body mass index (BMI) on increased risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is still questionable. The purpose of this retrospective study of a large cohort of adult patients transplanted for HCC was to investigate the effect of BMI on the incidence of HCC recurrence and outcome.Methods: Data from 427 adult recipients transplanted for HCC between 2000 and 2017 were collected.Patients were classified at time of LT according to the World Health Organization BMI classification into 3 groups; group 1: BMI <25 (n=166), group 2: BMI 25-29.9 (n=150) and group 3: BMI ≥30 (n=111).Results: There were no significant changes of mean BMI overtime 26.8±5.0 kg/m2 at time of LT and 28.8±23.1 at 5 years. The recurrence rates of HCC after LT in the three groups were 19%, 16% and 17% respectively. The 5, 10 and 15-year recurrence free survival (RFS) rates were respectively 68.6%, 47.3% and 40.8% in group 1, 73.3%, 66.2% and 49.5% in group 2 and 68.8%, 57.5% and 47.7% in group 3 (log rank P=0.47). Conclusion:Recipient BMI at time of transplant and during follow-up didn't impact the incidence of HCC recurrence nor long-term patient survival, irrespective to the status of the patients and their tumor characteristic at time of LT. The present study clearly confirms that obesity should not be considered, when selecting patients with HCC to LT, as a predictive factor of recurrence.

Outcomes in liver transplant recipients with nonalcoholic fatty liver disease-related HCC: results from the US multicenter HCC transplant consortium

“…Data from prior studies is conflicting; some previous studies with smaller patient cohorts have shown an association with higher BMI and diabetes and increased risk of post-LT HCC recurrence as well as decreased survival post-transplantation 33–36. The most recent and largest study prior to ours found that BMI at time of transplantation did not impact post-LT HCC recurrence nor long-term survival 37. It is clear that future studies using large datasets will be helpful to continue to explore the impact of these features on risk for HCC recurrence.…”

“…[33][34][35][36] The most recent and largest study prior to ours found that BMI at time of transplantation did not impact post-LT HCC recurrence nor long-term survival. [37] It is clear that future studies using large datasets will be helpful to continue to explore the impact of these features on risk for HCC recurrence.…”

Serum Total Superoxide Dismutase Activity as a Predictive Factor in Patients with Hepatocellular Carcinoma

“…Hepatocellular carcinoma (HCC), the most common form of primary liver cancer, ranks among the deadliest malignant tumors affecting humans (1,2). Major risk factors for HCC include hepatitis B (HBV) and hepatitis C (HCV) infections, excessive alcohol consumption, smoking, obesity, diabetes, and other metabolic disorders (3)(4)(5). Recent studies have highlighted that over 40% of new liver cancer cases worldwide are diagnosed in China (6).…”

The activity of metal-dependent superoxide dismutase as a predictive factor in patients with hepatocellular carcinoma

“…Hepatocellular carcinoma (HCC) as the most frequently occurring type of primary liver cancer is one of the most lethal human malignant tumors (1,2). Major risk factors of HCC include infections with hepatitis B (HBV), hepatitis C (HCV), excess alcohol intake, smoking, obesity, diabetes and other metabolic diseases (3)(4)(5).…”