Cancer Res Treat.  2018 Apr;50(2):530-537. 10.4143/crt.2017.156.

Body Composition Predicts Survival in Patients with Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

• Parikh ND
• Zhang P
• Singal AG
• Derstine B
• Krishnamurthy V
• Barman P
• Waljee AK
• Su GL

• KMID: 2411141
• DOI: http://doi.org/10.4143/crt.2017.156

Abstract

PURPOSE
The prognosis of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is often uncertain. We aimed to utilize analytic morphomics, a high-throughput imaging analysis, to assess if body composition is predictive of post-TACE survival.
MATERIALS AND METHODS
We included patients from a single center (Ann Arbor VA)who had TACE as the primary treatment forHCC and had a pre-treatment computed tomography scans. Univariate analysis and multivariate conditional inference tree analysis were utilized to identify the morphomic characteristics predictive of 1-year survival. Results were validated in an external cohort (University of Michigan Health System) of HCC patients who underwent TACE as their primary treatment.
RESULTS
In the 75 patients in the derivation cohort, median survival was 439 (interquartile range, 377 to 685) days from receipt of TACE, with 1-year survival of 61%. Visceral fat density (VFD) was the only morphomic factor predictive of overall and 1-year survival (p < 0.001). Patients with VFD above the 56th percentile had a 1-year survival of 39% versus 78% for those below the 56th percentile. VFD also correlated with 1-year survival in the external validation cohort (44% vs. 72%, p < 0.001). In a secondary analysis, patients with higher VFD were significantly more likely to experience hepatic decompensation after TACE (p < 0.001).
CONCLUSION
VFD served as an objective predictor of mortality in patients undergoing TACE, possibly through its ability to predict hepatic decompensation. VFD may serve as a radiographic biomarker in predicting TACE outcomes.

Keyword

Hepatocellular carcinoma; Chemoembolization; Therapeutic

MeSH Terms

Body Composition*
Carcinoma, Hepatocellular*
Cohort Studies
Humans
Intra-Abdominal Fat
Michigan
Mortality
Prognosis
Trees

Figure

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  Fig. 1. Kaplan-Meier survival of the derivation cohort (A) and the validation cohort (B) stratified by visceral fat density.

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  Fig. 2. Kaplan-Meier survival curve of all Child-Pugh class A patients from derivation and validation cohort stratified by visceral fat density.

Reference

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