Premium
Impact of postoperative changes in sarcopenic factors on outcomes after hepatectomy for hepatocellular carcinoma
Author(s) -
Kobayashi Atsushi,
Kaido Toshimi,
Hamaguchi Yuhei,
Okumura Shinya,
Taura Kojiro,
Hatano Etsuro,
Okajima Hideaki,
Uemoto Shinji
Publication year - 2016
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.302
Subject(s) - hepatectomy , medicine , sarcopenia , hepatocellular carcinoma , skeletal muscle , odds ratio , adipose tissue , indocyanine green , surgery , urology , gastroenterology , resection
Background We have reported that preoperative low skeletal muscle quality was an independent risk factor for poor outcomes after hepatectomy for hepatocellular carcinoma (HCC). However, postoperative changes of quality as well as quantity of skeletal muscle after hepatectomy for HCC and their impact on postoperative outcomes have not been fully investigated. Methods We retrospectively analyzed 241 patients undergoing primary hepatectomy for HCC between January 2007 and September 2012. The quality and quantity of skeletal muscle were evaluated by intramuscular adipose tissue content (IMAC) and the psoas muscle mass index (PMI) using computed tomography imaging at the umbilical level, respectively. We evaluated postoperative changes in IMAC and PMI in patients according to preoperative sarcopenia, sex, and surgical procedure. We also investigated the impact of ΔIMAC and ΔPMI on HCC recurrence in patients with preoperative normal IMAC. Results On multivariate analysis, indocyanine green retention test at 15 min ≥ 15% (odds ratio [OR] = 3.156; P = 0.041) and high ΔIMAC at 6 months after hepatectomy (OR = 3.713; P = 0.024) were the risk factors for HCC recurrence in patients with preoperative normal IMAC. Conclusion Postoperative depletion of skeletal muscle quality is closely involved with HCC recurrence after hepatectomy for HCC.