Lean body mass predicts postoperative liver failure in patients with hepatocellular carcinoma

Article type: Research Article

Authors: Liu, Zeng-Yao^{a; b; 1} | Xing, Zhao-Hui^{c; 1} | Wang, Wen^{a; 1} | Liu, Yu-Xi^a | Wang, Rui-Tao^{a; *} | Li, Jia-Yu^{d; *}

Affiliations: [a] Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, Heilongjiang, China | [b] Department of Interventional Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China | [c] Department of Urology Surgery, Heilongjiang Provincial Hospital, Harbin, Heilongjiang, China | [d] Institute of Intensive Care Unit, Heilongjiang Academy of Medical Science, Harbin, Heilongjiang, China

Correspondence: [*] Corresponding authors: Rui-Tao Wang, Department of Internal Medicine, Harbin Medical University Cancer Hospital, Harbin Medical University, No. 150 Haping Street, Nangang District, Harbin 150081, Heilongjiang, China. Tel.: +86 451 86298353; Fax: +86 451 86298352; E-mail: ruitaowang@126.com. Jia-Yu Li, Institute of Intensive Care Unit, Heilongjiang Academy of Medical Science, No. 150 Haping Street, Nangang District, Harbin 150081, Heilongjiang, %****␣cbm-35-cbm220172_temp.tex␣Line␣125␣**** China. Tel.: +86 18646174051; Fax: +86 451 86298352; E-mail: jiayu93@outlook.com.

Note: [1] Zeng-Yao Liu, Zhao-Hui Xing and Wen Wang contributed equally to this work.

Abstract: BACKGROUND: Post-hepatectomy liver failure (PHLF) is a severe complication of liver surgery in hepatocellular carcinoma (HCC) patients. Reduced lean body mass (LBM) decreases the immune activity and increases adverse clinical outcomes among cancer patients. OBJECTIVE: We aimed to assess the association between LBM and PHLF in HCC patients. METHODS: PHLF was defined and graded based on the International Study Group of Liver Surgery (ISGLS) criteria. Patients with Grade B or Grade C were included in PHLF ⩾ Grade B group, while others in PHLF < Grade B group. LBM was measured via preoperative computed tomography images. Binary logistic regression was applied for investigating the association between LBM and PHLF. The receiver operating characteristic curve was used to identify potential cut-off values and assess the predictive ability of the measured variables. RESULTS: The PHLF ⩾ Grade B group had significantly lower LBM levels (means ± standard deviation: 57.0 ± 14.1) than PHLF < Grade B group (67.2 ± 15.7) (p< 0.001). After controlling other variables, LBM was an independent protective factor for PHLF ⩾ Grade B (Odds Ratio: 0.406, 95% confidence interval: 0.172–0.957, p= 0.039). The prevalence of PHLF ⩾ Grade B in each quartile of LBM was 29.4% (15/51), 25.5% (13/51), 19.2% (10/52) and 4.0% (2/50), respectively (ptrend< 0.001). CONCLUSIONS: LBM might be a protective factor for PHLF in HCC patients. Our findings might help to develop a novel strategy to reduce the occurrence of hepatic dysfunction following major liver resection. Multicentric prospective studies and further molecular biologic investigation are needed.

Keywords: Hepatocellular carcinoma, postoperative, liver failure, lean body mass, liver resection

DOI: 10.3233/CBM-220172

Journal: Cancer Biomarkers, vol. 35, no. 4, pp. 419-427, 2022