Body Composition Predicts Survival in Patients with Hepatocellular Carcinoma Treated with Transarterial Chemoembolization.
- Author:
Neehar D PARIKH
1
;
Peng ZHANG
;
Amit G SINGAL
;
Brian A DERSTINE
;
Venkat KRISHNAMURTHY
;
Pranab BARMAN
;
Akbar K WALJEE
;
Grace L SU
Author Information
- Publication Type:Original Article
- Keywords: Hepatocellular carcinoma; Chemoembolization; Therapeutic
- MeSH: Body Composition*; Carcinoma, Hepatocellular*; Cohort Studies; Humans; Intra-Abdominal Fat; Michigan; Mortality; Prognosis; Trees
- From:Cancer Research and Treatment 2018;50(2):530-537
- CountryRepublic of Korea
- Language:English
- 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.
