studies

442A AASLD ABSTRACTS HEPATOLOGY, October, 2015
461
Etiological difference in body composition of patients
with hepatocellular carcinoma
Ryosuke Tateishi 1 , Naoto Fujiwara 1 , Hayato Nakagawa 1 , Yotaro
Kudo 1 , Ryo Nakagomi 1 , Mayuko Kondo 1 , Takuma Nakatsuka 1 ,
Tatsuya Minami 1 , Masaya Sato 1 , Koji Uchino 1 , Kenichiro Enooku 1 ,
Yuji Kondo 1 , Yoshinari Asaoka 1 , Yasuo Tanaka 1 , Kyoji Moriya 1 ,
Shuichiro Shiina 2 , Kazuhiko Koike 1 ; 1 Department of Gastroenterology,
The University of Tokyo Hospital, Tokyo, Japan; 2 Department
of Gastroenterology, Juntendo University, Tokyo, Japan
Background: We have reported that sarcopenia, intramuscular
fat deposition, and visceral adiposity indicate poor prognosis
of patients with hepatocellular carcinoma (HCC). To clarify the
etiological difference in body composition of HCC patients,
we compared visceral adipose tissue index (VATI), subcutaneous
adipose tissue index (SATI), and visceral to subcutaneous
adipose tissue ratio (VSR) among etiological groups in the
cohort. Methods: We enrolled naïve HCC patients diagnosed
from January 2004 to December 2009 in our department.
Patients were divided into 3 groups according to chronic viral
infection: hepatitis C virus (HCV), hepatitis B virus (HBV) and
non-viral etiology (NBNC). Those who were infected with both
hepatitis viruses were excluded. To minimize the tumor effect
on body composition, those with tumor larger than 5 cm were
also excluded. We assumed that visceral fat accumulation
increases inversely proportion to impact of virus related-risk of
HCC development (i.e., HCV>HBV>NBNC). Each component
of body composition was compared between two groups using
HCV group as a control. Results: Baseline characteristics of
enrolled patients were as follows: HCV group (N = 534, M/F
= 311/223, median age = 71), HBV group (N = 84, M/F
= 67/17, age = 61), and NBNC group (N = 126, M/F =
97/29, age = 71). Median (interquartile range [IQR]) tumor
size was 2.3 (1.8-2.9) cm. Number of tumor nodule was 1 in
404, 2-3 in 248, and more than 3 in 92 patients. Child-Pugh
class was A in 574, B in 164, C in 6. Significant difference
was observed in VATI between HBV and HCV groups in males
(P = 0.02) as well as between NBNC and HCV groups in
males (P 0.05).
11 patients were treated with CE + sorafenib. Advanced BCLC
stage disease, cirrhosis, and increasing MELD were statistically
significant predictors of decreased survival in univariate models.
In multivariate models the only statistically significant predictors
of improved survival included hepatitis B etiology and
treatment with resection or ablation (p