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Adipose Tissue Distribution Predicts Prognosis of Cirrhotic Patients Undergoing Hepatectomy for Hepatocellular Carcinoma

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Body composition data are reportedly correlated with patient prognosis for various cancers. However, little is known about the prognostic impact of adipose tissue distribution among patients with hepatocellular carcinoma (HCC).

Methods

Data for 181 consecutive cirrhotic patients who underwent hepatectomy for HCC were retrospectively reviewed. The clinical significance of the visceral-to-subcutaneous adipose tissue ratio (VSR) was investigated through analysis of short- and long-term surgical outcomes.

Results

Of the 181 patients, 60 (33%) were classified as the high-VSR group and 121 (67%) as the low-VSR group. Although VSR was not correlated with a risk of postoperative morbidity, multivariate analysis confirmed that a higher VSR was significantly correlated with a shorter time to interventional failure (hazard ratio [HR] 2.24; P = 0.008) and overall survival (HR 2.65; P = 0.001) independently of American Joint Committed on Cancer stage or preoperative nutritional status. Analysis of the recurrence patterns showed that the proportion of unresectable recurrence at the initial recurrence event was significantly higher in the high-VSR group (39% vs. 18%; P = 0.025). The yearly transition probabilities, defined by a Markov model from postoperative R0 status to advanced disease or death (7.6% vs. 1.5%, P < 0.001) and early recurrence stage to advanced disease or death (15.4% vs. 2.8%, P = 0.004), were higher in the high-VSR group, suggesting that patients with a higher VSR are vulnerable to disease progression.

Conclusion

A high VSR was found to be an independent predictor of disease progression and poor prognosis for HCC patients with underlying liver cirrhosis having resection for HCC.

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Acknowledgment

This study was supported by a grant from Okinaka Memorial Institute for Medical Disease.

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Author notes

  1. Satoshi Okubo and Junichi Shindoh have contributed equally to this work.

Authors and Affiliations

  1. Hepato-Biliary-Pancreatic Surgery Division, Department of Gastroenterological surgery, Toranomon Hospital, Minatoku, Tokyo, Japan

    Satoshi Okubo MD, PhD, Junichi Shindoh MD, Yuta Kobayashi MD, PhD, Ryosuke Umino MD, Miho Akabane MD, Kazutaka Kojima MD & Masaji Hashimoto MD, PhD

  2. Okinaka Memorial Institute for Medical Disease, Tokyo, Japan

    Junichi Shindoh MD

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  1. Satoshi Okubo MD, PhD
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  2. Junichi Shindoh MD
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Correspondence to Junichi Shindoh MD.

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Okubo, S., Shindoh, J., Kobayashi, Y. et al. Adipose Tissue Distribution Predicts Prognosis of Cirrhotic Patients Undergoing Hepatectomy for Hepatocellular Carcinoma. Ann Surg Oncol 28, 6738–6746 (2021). https://doi.org/10.1245/s10434-021-09658-9

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