Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria

Abstract To evaluate the association between sarcopenia and tumor recurrence after living donor liver transplantation (LDLT) in patients with advanced hepatocellular carcinoma (HCC), we analyzed 92 males who underwent LDLT for treating HCC beyond the Milan criteria. Sarcopenia was defined when the h...

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Autores principales:	Young Ri Kim, Sukhee Park, Sangbin Han, Joong Hyun Ahn, Seonwoo Kim, Dong Hyun Sinn, Woo Kyoung Jeong, Justin S. Ko, Mi Sook Gwak, Gaab Soo Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/390750555c4441a8bba7412fae8a142e
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spelling	oai:doaj.org-article:390750555c4441a8bba7412fae8a142e2021-12-02T12:32:36ZSarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria10.1038/s41598-018-25628-w2045-2322https://doaj.org/article/390750555c4441a8bba7412fae8a142e2018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-25628-whttps://doaj.org/toc/2045-2322Abstract To evaluate the association between sarcopenia and tumor recurrence after living donor liver transplantation (LDLT) in patients with advanced hepatocellular carcinoma (HCC), we analyzed 92 males who underwent LDLT for treating HCC beyond the Milan criteria. Sarcopenia was defined when the height-normalized psoas muscle thickness was <15.5 mm/m at the L3 vertebra level on computed tomography based on an optimum stratification method using the Gray’s test statistic. Survival analysis was performed with death as a competing risk event. The primary outcome was post-transplant HCC recurrence. The median follow-up time was 36 months. There was a 9% increase in recurrence risk per unit decrease in height-normalized psoas muscle thickness. Twenty-six (36.1%) of 72 sarcopenic recipients developed HCC recurrence, whereas only one (5.0%) of 20 non-sarcopenic recipients developed HCC recurrence. Recurrence risk was greater in sarcopenic patients in univariable analysis (hazard ratio [HR] = 8.06 [1.06–16.70], p = 0.044) and in multivariable analysis (HR = 9.49 [1.18–76.32], p = 0.034). Greater alpha-fetoprotein and microvascular invasion were also identified as independent risk factors. Incorporation of sarcopenia improved the model fitness and prediction power of the estimation model. In conclusion, sarcopenia appears to be one of the important host factors modulating tumor recurrence risk after LDLT for advanced HCC.Young Ri KimSukhee ParkSangbin HanJoong Hyun AhnSeonwoo KimDong Hyun SinnWoo Kyoung JeongJustin S. KoMi Sook GwakGaab Soo KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-11 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Young Ri Kim Sukhee Park Sangbin Han Joong Hyun Ahn Seonwoo Kim Dong Hyun Sinn Woo Kyoung Jeong Justin S. Ko Mi Sook Gwak Gaab Soo Kim Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
description	Abstract To evaluate the association between sarcopenia and tumor recurrence after living donor liver transplantation (LDLT) in patients with advanced hepatocellular carcinoma (HCC), we analyzed 92 males who underwent LDLT for treating HCC beyond the Milan criteria. Sarcopenia was defined when the height-normalized psoas muscle thickness was <15.5 mm/m at the L3 vertebra level on computed tomography based on an optimum stratification method using the Gray’s test statistic. Survival analysis was performed with death as a competing risk event. The primary outcome was post-transplant HCC recurrence. The median follow-up time was 36 months. There was a 9% increase in recurrence risk per unit decrease in height-normalized psoas muscle thickness. Twenty-six (36.1%) of 72 sarcopenic recipients developed HCC recurrence, whereas only one (5.0%) of 20 non-sarcopenic recipients developed HCC recurrence. Recurrence risk was greater in sarcopenic patients in univariable analysis (hazard ratio [HR] = 8.06 [1.06–16.70], p = 0.044) and in multivariable analysis (HR = 9.49 [1.18–76.32], p = 0.034). Greater alpha-fetoprotein and microvascular invasion were also identified as independent risk factors. Incorporation of sarcopenia improved the model fitness and prediction power of the estimation model. In conclusion, sarcopenia appears to be one of the important host factors modulating tumor recurrence risk after LDLT for advanced HCC.
format	article
author	Young Ri Kim Sukhee Park Sangbin Han Joong Hyun Ahn Seonwoo Kim Dong Hyun Sinn Woo Kyoung Jeong Justin S. Ko Mi Sook Gwak Gaab Soo Kim
author_facet	Young Ri Kim Sukhee Park Sangbin Han Joong Hyun Ahn Seonwoo Kim Dong Hyun Sinn Woo Kyoung Jeong Justin S. Ko Mi Sook Gwak Gaab Soo Kim
author_sort	Young Ri Kim
title	Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
title_short	Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
title_full	Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
title_fullStr	Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
title_full_unstemmed	Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria
title_sort	sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the milan criteria
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/390750555c4441a8bba7412fae8a142e
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Sarcopenia as a predictor of post-transplant tumor recurrence after living donor liver transplantation for hepatocellular carcinoma beyond the Milan criteria

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