Prognostic value of CT-derived body composition phenotypes for patients undergoing resection of hepatocellular
Zhaogang Zhang1, Tianyi Xia2,3, Hengtao Zhang1
1School of Medicine, Nankai University, Tianjin, China.
Objectives:
This study aimed to explore the prognostic value of body composition (BC) parameters derived from CT imaging and their derived phenotypes following resection of hepatocellular carcinoma (HCC).
Materials And Methods:
Retrospective collection of HCC patients who underwent liver resection at 5 medical centers. TotalSegmentator was employed to segment adipose and muscle tissues on CT images. Manual corrections were performed at the L3 level to extract tissue area and CT density parameters. Cox proportional hazards models were used to identify potential prognostic parameters for 2-year recurrence-free survival (RFS) and construct BC phenotypes. Further exploration was conducted on the prognostic value of the BC phenotypes.
Results:
A total of 497 patients were included (mean age, 59.3 ± 11.0 years; 396 men; cirrhosis prevalence, 53.50%), with a median follow-up of 38.1 months [95% CI, 35.2-44.8 months]. Among male patients, combining the subcutaneous adipose tissue (SAT) index and skeletal muscle (SM) density identified 3 phenotypes with significant survival differences: low risk (high SAT index and high SM density), high risk (low SAT index and low SM density), and intermediate risk (the remaining patients). The high-risk phenotype had a significantly lower 2-year RFS than the low-risk phenotype (HR: 2.34; 95% CI, 1.36-4.03), exceeding the prognosis value of individual BC parameters.
Conclusion:
BC phenotypes derived from SAT index and SM density provide superior risk stratification for 2-year RFS compared with individual BC parameters in male patients after HCC resection.