Alternative TitlePrognostic Value of Subcutaneous Adipose Tissue Volume in Hepatocellular Carcinoma Treated with Transcatheter Intra-arterial Therapy
経カテーテル的動脈内治療を受けた肝細胞癌患者における皮下脂肪量の予後予測能
Note (General)Background: Prognosis of patients with hepatocellular carcinoma (HCC) who undergo transcatheter intra-arterial therapies including transcatheter arterial chemoembolization and transcatheter arterial infusion chemotherapy is affected by many clinical factors including liver function and tumor progression. However, the effect of body composition such as skeletal muscle and visceral and subcutaneous adipose tissues (VAT and SAT, respectively) on the prognosis of these patients remains unclear. We investigated the prognostic value of body composition in HCC patients treated with transcatheter intra-arterial therapies. Patients and Methods: This study retrospectively evaluated 100 HCC patients treated with transcatheter intra-arterial therapies between 2005 and 2015. Areas of skeletal muscle, VAT, and SAT were measured on computed tomography images at third lumbar vertebra level and normalized by the height squared to calculate the skeletal muscle index, VAT index, and SAT index (SATI). Visceral to subcutaneous adipose tissue area ratio was also calculated. Overall survival (OS) was compared between high- and low-index groups for each body composition. Furthermore, prognostic significance was assessed by univariate and multivariate analyses using Cox proportional hazards models. Results: Among the body composition indexes, only SATI could significantly differentiate OS (P= .012). Multivariate analysis showed that SATI (low- vs. high-SATI; hazard ratio [HR], 2.065; 95% confidence interval [CI], 1.187-3.593; P= .010), serum albumin (<3.5 vs. ≥3.5 g/dL; HR, 2.007; 95% CI, 1.037-3.886; P= .039), serum alpha-fetoprotein (<20 vs. ≥20 ng/mL; HR, 0.311; 95% CI, 0.179-0.540; P< .001), and mRECIST assessment (complete response + partial response + stable disease vs. progressive disease; HR, 0.392; 95% CI, 0.221-0.696; P= .001) were indicated as independent prognostic factors for OS. Conclusions: High SAT volume is associated with better survival outcomes in HCC patients treated with transcatheter intra-arterial therapies. Elucidation of the mechanisms regulating SAT volume may offer new therapeutic strategy in these patients.
学位の種類: 博士（医学）. 報告番号: 甲第4491号. 学位記番号: 新大院博（医）甲第828号. 学位授与年月日: 平成30年9月20日
Cancer Management and Research. 2018, 10, 2231-2239.
新大院博（医）甲第828号
開始ページ : 1
終了ページ : 28
DOIinfo:doi/10.2147/CMAR.S167417
Collection (particular)国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
Date Accepted (W3CDTF)2019-01-04T08:16:43+09:00
Data Provider (Database)国立国会図書館 : 国立国会図書館デジタルコレクション