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Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma
Author(s) -
Hamaguchi Yuhei,
Kaido Toshimi,
Okumura Shinya,
Ito Takashi,
Fujimoto Yasuhiro,
Ogawa Kohei,
Mori Akira,
Hammad Ahmed,
Hatano Etsuro,
Uemoto Shinji
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.236
Subject(s) - hepatectomy , hepatocellular carcinoma , medicine , sarcopenia , adipose tissue , hazard ratio , skeletal muscle , gastroenterology , retrospective cohort study , urology , surgery , oncology , confidence interval , resection
Background Sarcopenia has been shown to be an independent predictor of lower disease‐free and overall survival in various kinds of diseases. The quality of skeletal muscle has recently attracted much attention as a new parameter of sarcopenia. Methods We performed a retrospective analysis of 477 patients undergoing hepatectomy for hepatocellular carcinoma (HCC) between April 2005 and August 2014. The quality of skeletal muscle was evaluated by intramuscular adipose tissue content (IMAC) using preoperative computed tomography (CT) imaging. The impact of IMAC on outcomes after hepatectomy for HCC was analyzed. Results Patients with high IMAC showed older age, higher body mass index, higher indocyanine green retention test at 15 min, and more operative blood loss. The overall and recurrence‐free survival rates were significantly lower in patients with high IMAC than in patients with normal IMAC ( P < 0.0001, P = 0.0012, respectively). Multivariate analysis showed that high IMAC was the significant risk factor for death (hazard ratio [HR] = 2.942; P < 0.0001) and for HCC recurrence (HR = 1.529; P = 0.0007) after hepatectomy. Conclusions 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.