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Body composition may predict HCC-related outcomes

Various body composition components, including sarcopenia, intramuscular fat deposition and visceral adiposity, were accurate in predicting mortality and other outcomes in patients with hepatocellular carcinoma, according to study findings.

“In the present study, we explored BMI, skeletal muscle area, intramuscular fat deposition, abdominal adipose tissue area and adipose tissue distribution in a large-scale retrospective cohort of 1,257 patients with different stages of HCC and comprehensively analyzed the impact of body composition on the prognoses of such patients,” the researchers wrote.

Using a prospective computerized database, researchers in Japan measured skeletal muscle index (SMI), mean muscle attenuation (MA), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI) and visceral to subcutaneous adipose tissue area ratios (VSR) using CT in patients with different stages of HCC. The patients were all diagnosed with HCC at the University of Tokyo Hospital between January 2004 and December 2009 (mean age: 68.8 ± 9.2 years).

Analyses showed that obesity and underweight status were associated with higher mortality among these patients, of which a majority had HCV-related HCC.

“This result suggests that the U-shaped relationship between BMI and mortality is common, regardless of underlying liver disease,” the researchers wrote.

Of the five indicators of body composition, SATI was strongly correlated with BMI and SMI and VATI were moderately correlated with BMI. However, MA and VSR were weakly correlated with BMI, indicating that “BMI cannot be used to accurately assess individual body composition components,” according to the researchers.

Further analysis showed SMI (P = .009) and MA (P = .024) to be linked to mortality, and higher VSR was linked to poor prognosis (P = .11). VATI and SATI were not found to be associated with mortality.

Multivariate analysis showed that sarcopenia (HR = 1.52; 95% CI, 1.18-1.96), IMF deposition (HR=1.34; 95% CI, 1.05-1.71) and visceral adiposity (HR = 1.35; 95% CI, 1.09-1.66) to be predictors for survival. BMI was not a significant predictor of survival, the researchers noted.

The prevalence of poor prognostic body composition components was higher in underweight and obese patients compared with patients of a normal weight.

“Body composition rather than BMI is important in terms of survival of HCC patients, independent of liver function reserve and cancer stage,” the researchers concluded. “Variations in the impact of BMI on survival were explained in part by differences in body composition.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.