Itoh Shinji, Shirabe Ken, Matsumoto Yoshihiro, Yoshiya Shohei, Muto Jun, Harimoto Norifumi, Yamashita Yo-Ichi, Ikegami Toru, Yoshizumi Tomoharu, Nishie Akihiro, Maehara Yoshihiko
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan,
Ann Surg Oncol. 2014 Sep;21(9):3063-8. doi: 10.1245/s10434-014-3686-6. Epub 2014 Apr 10.
To evaluate the effect of body composition on outcomes after hepatic resection for patients with hepatocellular carcinoma (HCC).
We performed 190 hepatic resections for HCC and divided the patients into 2 groups on the basis of visceral fat area (VFA), assessed by computed tomographic measurement at the level of the umbilicus, into high VFA (H-VFA) (n = 106) and low VFA (L-VFA) (n = 84) groups. We compared the surgical outcomes between the two groups.
L-VFA was significantly correlated with a lower body mass index, sarcopenia, lower serum albumin, and liver cirrhosis. There was no difference in the incidence of postoperative complications and mortality between the 2 groups. Patients in the L-VFA group had a significantly poorer prognosis than those in the H-VFA group in terms of both overall (P = 0.043) and recurrence-free (P = 0.001) survival. The results of multivariate analysis showed that sarcopenia rather than L-VFA was an independent and prognostic indicator after hepatic resection with HCC.
Body composition is an important factor affecting cancer outcomes after hepatic resection for HCC in Japan.
评估身体组成对肝细胞癌(HCC)患者肝切除术后结局的影响。
我们对190例HCC患者进行了肝切除术,并根据通过脐水平的计算机断层扫描测量评估的内脏脂肪面积(VFA)将患者分为两组,即高VFA(H-VFA)组(n = 106)和低VFA(L-VFA)组(n = 84)。我们比较了两组之间的手术结局。
L-VFA与较低的体重指数、肌肉减少症、较低的血清白蛋白和肝硬化显著相关。两组之间术后并发症发生率和死亡率无差异。就总生存期(P = 0.043)和无复发生存期(P = 0.001)而言,L-VFA组患者的预后明显比H-VFA组差。多变量分析结果显示,肌肉减少症而非L-VFA是HCC肝切除术后的独立预后指标。
在日本,身体组成是影响HCC肝切除术后癌症结局的重要因素。