Publication Abstract

Authors: Parikh ND, Zhang P, Singal AG, Derstine BA, Krishnamurthy V, Barman P, Waljee AK, Su GL

Title: Body Composition Predicts Survival in Patients with Hepatocellular Carcinoma Treated with Transarterial Chemoembolization.

Journal: Cancer Res Treat :-

Date: 2017 Jun 01

Abstract: Purpose: The prognosis of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is often uncertain. We aimed to utilize analytic morphomics, a high-throughput imaging analysis, to assess if body composition is predictive of post-TACE survival. Materials and Methods: We included patients from a single center (Ann Arbor VA) who had TACE as the primary treatment for HCC and had a pre-treatment CT scans. Univariate analysis and multivariate conditional inference tree analysis were utilized to identify the morphomic characteristics predictive of one-year survival. Results: were validated in an external cohort (University of Michigan Health System) of HCC patients who underwent TACE as their primary treatment. Results: In the 75 patients in the derivation cohort, median survival was 439 (IQR: 377-685) days from receipt of TACE, with 1-year survival of 61%. Visceral fat density (VFD) was the only morphomic factor predictive of overall and 1-year survival (p<0.001). Patients with VFD above the 56th percentile had a 1-year survival of 39% vs. 78% for those below the 56th percentile. VFD also correlated with 1-year survival in the external validation cohort (44% vs. 72%, p<0.001). In a secondary analysis, patients with higher VFD were significantly more likely to experience hepatic decompensation after TACE (p<0.001). Conclusions: VFD served as an objective predictor of mortality in patients undergoing TACE, possibly through its ability to predict hepatic decompensation. VFD may serve as a radiographic biomarker in predicting TACE outcomes.