Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma
Preoperative intramuscular adipose tissue content is a novel prognostic predictor after hepatectomy for hepatocellular carcinoma
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DOI：
10.1002/jhbp.236
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发表时间：
2015-06-01
影响因子：
3
通讯作者：
Uemoto, Shinji
中科院分区：
文献类型：
--
作者：
Hamaguchi, Yuhei;Kaido, Toshimi;Uemoto, Shinji
研究背景肉瘤减少症已被证明是各种疾病的无病生存率和总存活率降低的独立预测指标。方法对2005年4月至2014年8月477例肝细胞癌患者行肝切除术的临床资料进行回顾性分析。术前CT成像通过肌内脂肪组织含量(IMAC)评价骨骼肌质量。结果iMac高的患者年龄大、体重指数高、15min吲哚青绿滞留试验高、术中失血量多。高IMAC患者的总生存率和无复发生存率显著低于IMAC正常患者(P<；0.0001，P=0.0012)。多因素分析显示，高IMAC是肝切除后死亡(危险性比[HR]=2.942；P<；0.0001)和复发(HR=1.529；P=0.0007)的显著危险因素。结论术前骨骼肌质量与术后死亡率和肝癌复发密切相关。IMAC可作为肝细胞癌新的肝切除选择标准。
BackgroundSarcopenia has been shown to be an independent predictor of lower disease-free and overall survival in various kinds of diseases. The quality of skeletal muscle has recently attracted much attention as a new parameter of sarcopenia.MethodsWe performed a retrospective analysis of 477 patients undergoing hepatectomy for hepatocellular carcinoma (HCC) between April 2005 and August 2014. The quality of skeletal muscle was evaluated by intramuscular adipose tissue content (IMAC) using preoperative computed tomography (CT) imaging. The impact of IMAC on outcomes after hepatectomy for HCC was analyzed.ResultsPatients with high IMAC showed older age, higher body mass index, higher indocyanine green retention test at 15min, and more operative blood loss. The overall and recurrence-free survival rates were significantly lower in patients with high IMAC than in patients with normal IMAC (P < 0.0001, P = 0.0012, respectively). Multivariate analysis showed that high IMAC was the significant risk factor for death (hazard ratio [HR] = 2.942; P < 0.0001) and for HCC recurrence (HR = 1.529; P = 0.0007) after hepatectomy.ConclusionsPreoperative quality of skeletal muscle was closely correlated with postoperative mortality and HCC recurrence. IMAC could be incorporated into new selection criteria for hepatectomy for HCC.