Visceral Adiposity Is Associated with Increased Recurrence of Hepatocellular Carcinoma Following Liver Transplantation.
Abdominal Transplant, Columbia University, Ny, NY.
Meeting: 2016 American Transplant Congress
Abstract number: 110
Keywords: Hepatocellular carcinoma, Obesity
Session Information
Session Name: Concurrent Session: Hepatic Malignancies
Session Type: Concurrent Session
Date: Sunday, June 12, 2016
Session Time: 4:30pm-6:00pm
Presentation Time: 5:42pm-5:54pm
Location: Room 304
Introduction
Obesity has become a worldwide epidemic. The number of patients with HCC undergoing Orthotopic liver transplant (OLT) is rising. Epidemiologic evidence suggests a link between obesity and HCC. This is believed to occur by a production of protumorogenic adipocytokines by adipose tissue.
Body mass index (BMI), a composite measure of subcutaneous and visceral adiposity, has been used as a marker for obesity. However, it is now known that visceral but not subcutaneous fat is metabolically active and is alone responsible for the secretion of a protumorogenic systemic-mileu.
Hypothesis
We hypothesize that visceral adiposity measured by MRI is a prognostic indicator of oncologic outcomes after OLT for HCC and, MRI measures of visceral adiposity correlate with oncologically inferior explant pathology.
Methods
From January 1999-January 2013 we identified 423 patients with HCC who underwent OLT and had MRI imaging preOLT. Peri-renal fat thickness, a standardized measure of visceral obesity, was calculated on all MRI scans. Demographics and BMI, HCC recurrence, days to recurrence, and survival were measured. All explant pathology was reviewed. Student's t test, Chi-Square and Kaplan Meier curves were used as appropriate.
Results
Mean MELD was 22±8. No differences were noted in MELD across spectrum of BMI or peri-renal fat thickness. Total recurrence rate =12%.
| Peri-renal fat size | 0-5mm(n=19) | 5-10mm(n=38) | 10-15mm(n=72) | 15-20mm(n=46) | 20-25mm(n=34) | 25-30mm(n=24) | ≥30mm(n=21) |
| % HCC Recurrence rate |
0 |
7.9 |
13.9 |
10.9 |
14.7* |
16.7* |
14.3* |
| Time to recurrence (days) (mean) | N/A | 781 |
811 |
588 |
279* |
172* |
676 |
| %Microvascular Invasion | 10.5 | 21.1 | 16.7 | 21.7 | 23.5 | 12.5 |
38.1* |
| %Lymphovascular Invasion |
0 |
0 |
1.4 | 0 | 8.8 | 4.2 | 4.8 |
| %Poor Differentiated |
5.2 |
7.9 |
12.5 |
13.0 |
23.5* |
16.7 |
23.8* |
| *p<0.05 vs perirenal fat thickness <20mm |
Conclusions
These data show that increasing visceral adiposity is associated with increased recurrence and hastened time to recurrence. Additionally, visceral adiposity is associated with oncologically inferior explant pathology. Therefore, visceral adiposity in patients with HCC should be used as a prognostic marker to determine appropriate allocation of livers in HCC recipients with similar MELD scores.
CITATION INFORMATION: Mathur A, Boyangzi L, Prince M, Guarrera J, Samstein B, Griesemer A, Halazun K, Kato T, Emond J. Visceral Adiposity Is Associated with Increased Recurrence of Hepatocellular Carcinoma Following Liver Transplantation. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Mathur A, Boyangzi L, Prince M, Guarrera J, Samstein B, Griesemer A, Halazun K, Kato T, Emond J. Visceral Adiposity Is Associated with Increased Recurrence of Hepatocellular Carcinoma Following Liver Transplantation. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/visceral-adiposity-is-associated-with-increased-recurrence-of-hepatocellular-carcinoma-following-liver-transplantation/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress