von Hessen Leona, Roumet Marie, Maurer Martin Helmut, Lange Naomi, Reeves Helen, Dufour Jean-François, Radu Pompilia
Hepatology, Department of Clinical Research, University of Bern, Bern, Switzerland.
University Clinic for Visceral Surgery and Medicine, Inselspital Bern, Bern, Switzerland.
Liver Int. 2021 Apr;41(4):828-836. doi: 10.1111/liv.14755. Epub 2020 Dec 18.
BACKGROUND & AIMS: Body composition parameters have been reported to add information, which can lead to tailored treatment and prognostication for oncological patients. Data for patients with hepatocellular carcinoma (HCC) are scarce. We assessed the association between different body composition parameters and overall survival (OS) in two different newly diagnosed HCC populations.
The area (cm ) and density (Hounsfield Units [HU]) of skeletal muscle (SM) and adipose tissue (subcutaneous [SAT], visceral [VAT] and intermuscular [IMAT]) were measured on computed tomography (CT) scans at the level of the third lumbar vertebra (L3) in two cohorts of patients diagnosed in different HCC stages (Bern, Switzerland n = 187 and Newcastle, United Kingdom n = 216). Univariate and multivariate Cox regressions analyses were used to assess the crude and adjusted association of body composition parameters with OS.
By univariate analysis, in both cohorts, Bern and Newcastle, high SAT density (hazard ratio [HR]: 1.35; 1.12-1.62, P < .001 and 1.44; 1.27-1.63, P < .001, respectively) and high VAT density (HR: 1.38; 1.1-1.72, P = .005 and HR: 1.53; 1.3-1.81, P < .001, respectively) correlated negatively with survival. After model adjustment for potential baseline confounders (gender, age, diabetes, cirrhosis, MELD score, BCLC stage) in a multivariate analysis, SAT density remained associated with mortality in Bern and Newcastle (Bern: HR: 1.27; 1.04-1.57, P = .022; Newcastle: HR: 1.23; 1.03-1.48, P = .022) and VAT remained associated with mortality in Bern (HR: 1.31; 1.05-1.65, P = .019).
Based on two HCC cohorts, our data show that high SAT density correlates negatively with OS in HCC patients.
据报道，身体成分参数可提供额外信息，有助于为肿瘤患者制定个性化治疗方案并进行预后评估。肝细胞癌（HCC）患者的数据较为匮乏。我们评估了两个不同的新诊断HCC人群中不同身体成分参数与总生存期（OS）之间的关联。
在两个不同HCC分期的患者队列（瑞士伯尔尼，n = 187；英国纽卡斯尔，n = 216）中，于第三腰椎（L3）水平进行计算机断层扫描（CT），测量骨骼肌（SM）以及脂肪组织（皮下脂肪[SAT]、内脏脂肪[VAT]和肌间脂肪[IMAT]）的面积（cm²）和密度（亨氏单位[HU]）。采用单因素和多因素Cox回归分析评估身体成分参数与OS的粗关联和调整后关联。
单因素分析显示，在伯尔尼和纽卡斯尔这两个队列中，高SAT密度（风险比[HR]：1.35；95%置信区间[CI]：1.12 - 1.62，P <.001；以及HR：1.44；95% CI：1.27 - 1.63，P <.001）和高VAT密度（HR：1.38；95% CI：1.1 - 1.72，P =.005；以及HR：1.53；95% CI：1.3 - 1.81，P <.001）均与生存期呈负相关。在多因素分析中对潜在基线混杂因素（性别、年龄、糖尿病、肝硬化、终末期肝病模型[MELD]评分、巴塞罗那临床肝癌[BCLC]分期）进行模型调整后，SAT密度在伯尔尼和纽卡斯尔仍与死亡率相关（伯尔尼：HR：1.27；95% CI：1.04 - 1.57，P =.022；纽卡斯尔：HR：1.23；95% CI：1.03 - 1.48，P =.022），VAT在伯尔尼仍与死亡率相关（HR：1.31；95% CI：1.05 - 1.
