Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma

Hamaguchi, Yuhei; Kaido, Toshimi; Okumura, Shinya; Ito, Takashi; Fujimoto, Yasuhiro; Ogawa, Kohei; Mori, Akira; Hammad, Ahmed; Hatano, Etsuro; Üemoto, Shinji

doi:10.1002/jhbp.236

Cited by 113 publications

(117 citation statements)

References 28 publications

(35 reference statements)

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“…In addition, in patients undergoing hepatectomy for HCC, the overall and recurrence-free survival rates were significantly lower in patients with high IMAC values than in patients with normal IMAC values (p<0.001, p=0.001, respectively; fig. 2a, b) [30]. On multivariate analysis, preoperative low quality of skeletal muscle evaluated by IMAC was an independent risk factor for poor survival in patients undergoing LDLT and in patients undergoing hepatectomy for HCC [29,30].…”

Section: Significance Of Sarcopeniamentioning

confidence: 99%

“…2a, b) [30]. On multivariate analysis, preoperative low quality of skeletal muscle evaluated by IMAC was an independent risk factor for poor survival in patients undergoing LDLT and in patients undergoing hepatectomy for HCC [29,30]. The mechanisms by which low quality of skeletal muscle accompanies an increased risk of mortal- Color version available online…”

Section: Significance Of Sarcopeniamentioning

confidence: 99%

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Selection Criteria and Current Issues in Liver Transplantation for Hepatocellular Carcinoma

Kaido

2016

Liver Cancer

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Liver transplantation (LT) is an ideal treatment for hepatocellular carcinoma (HCC) because it not only resects HCCs but it also replaces the underlying damaged liver with normal tissue. However, the selection criteria are still a matter of debate. After the introduction of the Milan criteria, some expanded criteria focusing on tumor size and number have been proposed. In addition, new expanded criteria considering tumor biology have been proposed using tumor markers and ¹⁸F-fluorodeoxyglucose positron emission tomography. This review summarizes the selection criteria in LT for HCC and introduces current issues focusing on the treatment for hepatitis C virus infection and the significance of sarcopenia in this field.

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Section: Significance Of Sarcopeniamentioning

confidence: 99%

Section: Significance Of Sarcopeniamentioning

confidence: 99%

Selection Criteria and Current Issues in Liver Transplantation for Hepatocellular Carcinoma

Kaido

2016

Liver Cancer

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“…The median duration of follow-up for these patients was 42.6 months (interquartile range [IQR] 19.7-71.7). Details about the surgical procedures of hepatectomy, pathological examination, and follow-up after hepatectomy have been described previously [25,26].…”

Section: Patientsmentioning

confidence: 99%

Preoperative Visceral Adiposity and Muscularity Predict Poor Outcomes after Hepatectomy for Hepatocellular Carcinoma

et al. 2018

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Objective: Visceral adiposity, defined as a high visceral-to-subcutaneous adipose tissue area ratio (VSR), has been shown to be associated with poor outcomes in several cancers. However, in the surgical field, the significance of visceral adiposity remains controversial. The present study investigated the impact of visceral adiposity as well as sarcopenic factors (low muscularity) on outcomes in patients undergoing hepatectomy for hepatocellular carcinoma (HCC). Patients and Methods: This retrospective study analyzed data from 606 patients undergoing hepatectomy for HCC at our institution between April 2005 and March 2016. Using preoperative plain computed tomography imaging at the level of the third lumbar vertebra, visceral adiposity, skeletal muscle mass, and muscle quality were evaluated by the VSR, skeletal muscle mass index (SMI), and intramuscular adipose tissue content (IMAC), respectively. The impact of these parameters on outcomes after hepatectomy for HCC was analyzed. Results: The overall survival rate was significantly lower among patients with a high VSR (p < 0.001) than among patients with a normal VSR. Similarly, the recurrence-free survival rate was significantly lower among patients with a high VSR (p = 0.016). A high VSR, low SMI, and high IMAC contributed to an increased risk of death (p < 0.001) and HCC recurrence (p < 0.001) in an additive manner. Multivariate analysis showed that not only preoperative low muscularity but also visceral adiposity was a significant risk factor for mortality (hazard ratio [HR] = 1.566, p < 0.001) and HCC recurrence (HR = 1.329, p = 0.020) after hepatectomy for HCC. Conclusions: Preoperative visceral adiposity, as well as low muscularity, was closely related to poor outcomes after hepatectomy for HCC. It is crucial to establish a new strategy including perioperative nutritional interventions with rehabilitation for better outcomes after hepatectomy for HCC.

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“…Sarcopenia is thus not only a condition affecting the elderly and can be observed at any age as a result of inflammatory conditions (including malignancies), malnutrition, and disuse. We have so far reported the negative impacts of preoperative sarcopenia on outcomes after living donor liver transplantation [4,5], hepatocellular carcinoma (HCC) [6,7], extrahepatic biliary malignancies [8], and pancreatic cancer [9]. Various lines of evidence have also shown that sarcopenia is predictive of mortality in various diseases and after various surgeries [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

et al. 2017

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Background: Sarcopenia is a prognostic factor for mortality in digestive surgery. However, the correlation between preoperative cardiopulmonary function and sarcopenia in patients undergoing hepatectomy for hepatocellular carcinoma (HCC) remains unclear. Methods: The present study investigated the impact of preoperative sarcopenia on cardiopulmonary function in 402 patients who underwent first hepatectomy for HCC between April 2005 and April 2015. The quantity and quality of skeletal muscle were evaluated using psoas muscle index (PMI) and intramuscular adipose tissue content (IMAC), respectively, as determined from preoperative computed tomography imaging. Correlations between preoperative cardiopulmonary function and sarcopenic factors (PMI and IMAC) were evaluated. Results: No significant correlations were found between left ventricular ejection fraction and the two sarcopenic factors. On the other hand, preoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV₁) correlated significantly with PMI (p < 0.001 each) in males and with IMAC (p < 0.001 each) in females. Moreover, VC and FEV₁ in the preoperative low PMI (p < 0.001 each) and high IMAC (p = 0.002 and p < 0.001, respectively) groups were significantly lower than in the normal group in males. In females, VC and FEV₁ were significantly lower in the preoperative high IMAC group than in the normal group (p < 0.001 each). Conclusion: Preoperative low muscle mass in males and low muscle quality in males and females were significantly associated with pulmonary dysfunction.

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Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma

Abstract: Preoperative quality of skeletal muscle was closely correlated with postoperative mortality and HCC recurrence. IMAC could be incorporated into new selection criteria for hepatectomy for HCC.

Cited by 113 publications

References 28 publications

Selection Criteria and Current Issues in Liver Transplantation for Hepatocellular Carcinoma

Selection Criteria and Current Issues in Liver Transplantation for Hepatocellular Carcinoma

Preoperative Visceral Adiposity and Muscularity Predict Poor Outcomes after Hepatectomy for Hepatocellular Carcinoma

Preoperative Low Muscle Mass and Low Muscle Quality Negatively Impact on Pulmonary Function in Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

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