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Cancer Res Treat. 2018 Apr;50(2):530-537. doi: 10.4143/crt.2017.156. Epub 2017 Jun 1.

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

Author information

1
Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, USA.
2
VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
3
Department of Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
4
Morphomic Analysis Group, University of Michigan Medical School, Ann Arbor, MI, USA.
5
Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX, USA.
6
Veterans Affairs Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.

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 MichiganHealth System) ofHCC patientswho 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.

KEYWORDS:

Chemoembolization; Hepatocellular carcinoma; Therapeutic

PMID:
28602057
PMCID:
PMC5912126
DOI:
10.4143/crt.2017.156
[Indexed for MEDLINE]
Free PMC Article

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