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Imaging based body composition profiling and outcomes after oncologic liver surgery.

Lorenzo Bernardi1, Raffaello Roesel1, Filippo Vagelli2

  • 1Department of Visceral Surgery, Lugano Regional Hospital, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.

Frontiers in Oncology
|December 26, 2022
PubMed
Summary

Body composition analysis, including sarcopenia and obesity, using CT scans can predict patient outcomes after liver surgery for cancer. This review examines current evidence on body composition

Keywords:
body compositioncancer imagingliver resectionliver surgerymusclesarcopenia

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Area of Science:

  • Oncology
  • Radiology
  • Surgical Outcomes

Background:

  • Body composition profiling is increasingly recognized as a crucial pre-operative predictor for oncologic liver surgery outcomes.
  • Current research predominantly relies on retrospective, single-institution studies using CT-derived body composition parameters.
  • While sarcopenia is well-studied, other phenotypes like sarcopenic obesity, visceral fat, myosteatosis, and bone mineral density also warrant investigation.

Purpose of the Study:

  • To review and synthesize existing evidence on the impact of imaging-based body composition parameters on patient outcomes.
  • To specifically analyze outcomes for major liver resection indications: hepatocellular carcinoma (HCC), cholangiocarcinoma (CCA), and colorectal liver metastases (CRLM).

Main Methods:

  • Systematic review of literature focusing on CT-scan-derived body composition metrics.
  • Analysis of studies correlating body composition phenotypes with short- and long-term outcomes in liver surgery patients.
  • Categorization of findings based on primary liver cancer indications (HCC, CCA, CRLM).

Main Results:

  • Sarcopenia is a significant predictor, but other body composition factors like visceral adiposity and myosteatosis also influence outcomes.
  • Evidence suggests a link between various body composition profiles and post-operative results in HCC, CCA, and CRLM patients.
  • The heterogeneity of studies highlights the need for standardized methodologies in body composition assessment.

Conclusions:

  • Imaging-based body composition parameters are valuable for predicting outcomes in patients undergoing liver resection for primary liver cancers and metastases.
  • A comprehensive assessment beyond sarcopenia, including obesity and fat infiltration, is essential for personalized pre-operative risk stratification.
  • Further standardized research is needed to fully elucidate the role of diverse body composition phenotypes in oncologic liver surgery.