Effect of Intramuscular Adipose Tissue Content on Prognosis in Patients Undergoing Hepatocellular Carcinoma Resection

J Gastrointest Surg. 2015 Jul;19(7):1315-23. doi: 10.1007/s11605-015-2838-8. Epub 2015 May 12.


Background: It has recently been reported that myosteatosis, the infiltration of fat in skeletal muscle, is associated with insulin resistance and type 2 diabetes mellitus. The present study investigated the effect of skeletal muscle fat accumulation on short- and long-term outcomes following partial hepatectomy for hepatocellular carcinoma (HCC) and aimed to identify prognostic factors.

Methods: The records of 141 HCC patients who underwent hepatectomy were retrospectively reviewed. Clinicopathological and outcome data from 71 patients with high intramuscular adipose tissue content (IMAC) were compared with those from 70 patients with low IMAC.

Results: The 5-year overall survival rate was 46% among patients with high IMAC and 75% among those with low IMAC. The 5-year disease-free survival rates in these groups were 18 and 38%, respectively. Multivariate analysis revealed that high IMAC was predictive of an unfavorable prognosis. High IMAC was significantly correlated with liver dysfunction, higher intraoperative blood loss, the need for blood transfusion, and comorbid diabetes mellitus.

Conclusions: Greater fat accumulation in skeletal muscle was predictive of worse overall survival after partial hepatectomy in patients with HCC, even with adjustment for other known predictors. The identification of patients with greater skeletal muscle fat accumulation before hepatectomy could permit early preventive strategies to maintain muscle quality and thus improve prognosis and patient selection for hepatectomy.

MeSH terms

  • Adipose Tissue / pathology*
  • Aged
  • Blood Loss, Surgical
  • Blood Transfusion
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / physiopathology
  • Carcinoma, Hepatocellular / surgery*
  • Diabetes Mellitus, Type 2 / complications
  • Disease-Free Survival
  • Female
  • Hepatectomy / adverse effects
  • Humans
  • Liver / physiopathology
  • Liver Neoplasms / complications
  • Liver Neoplasms / physiopathology
  • Liver Neoplasms / surgery*
  • Male
  • Muscle, Skeletal / pathology*
  • Retrospective Studies
  • Survival Rate