Impact of body composition on survival and morbidity after liver resection in hepatocellular carcinoma patients

作     者：Andreas Kroh Diane Uschner Toine Lodewick Roman M Eickhoff Wenzel Sch?ning Florian T Ulmer Ulf P Neumann Marcel Binneb?sel 

作者机构：Department of General Visceral and Transplant Surgery University Hospital RWTH Aachen Institute of Medical Statistics University Hospital RWTH Aachen Department of Surgery Maastricht University Medical Center Department of Radiology Zuyderland Medical Centre Department of Radiology Maastricht University Medical Centre 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2019年第18卷第1期

页      面：28-37页

核心收录：

学科分类：10[医学] 

基　　金：This study was approved by the local ethics committee(EK 343/15) was conducted in accordance to the principles of the Declaration of Helsinki and 'good clinical practice' guidelines 

主　　题：Hepatocellular carcinoma Sarcopenia Obesity Sarcopenic obesity Liver resection 

摘      要：Background: Hepatocellular carcinoma is the most common innate liver tumor. Due to improved surgical techniques, even extended resections are feasible, and more patients can be treated with curative intent. As the liver is the central metabolic organ, preoperative metabolic assessment is crucial for risk stratification. Sarcopenia, obesity and sarcopenic obesity characterize body composition and metabolic status. Here we present the impact of body composition on survival after liver resection in patients with hepatocellular carcinoma. Methods: A retrospective database analysis of 70 patients who were assigned for liver resection due to hepatocellular carcinoma was conducted. For assessment of sarcopenia and obesity, skeletal muscle surface area was measured at lumbar vertebra 3 level(L3) in preoperative four-phase contrast enhanced abdominal CT scans, and L3 muscle index and body fat percentage were calculated. Results: Univariate analysis comparing the survival curves using the score test demonstrated superior postoperative overall survival for sarcopenic( P = 0.035) and sarcopenic obese( P = 0.048) patients as well as a trend favoring obese( P = 0.130) subjects. Whereas multivariate analysis could not identify significant difference in postoperative survival regarding sarcopenia, obesity or sarcopenic obesity. Only large tumor size, multifocal disease and male gender were risk factors for long-term survival. Conclusions: Sarcopenia, obesity and sarcopenic obesity are indeed no risk factors for poor postoperative survival in this study. Our data do not support the evaluation of sarcopenia, obesity and sarcopenic obesity before liver resection in hepatocellular carcinoma patients.