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Clinical Research

Association between visceral obesity and tumor recurrence in hepatocellular carcinoma recipients undergoing liver transplantation

International Journal of Obesity volume 47, pages 1214–1223 (2023)Cite this article

Subjects

Abstract

Background

Excessive visceral obesity in recipients of living donor liver transplantation (LDLT) is associated with mortality, and a recent study reported the correlation between visceral adiposity of male LDLT recipients and hepatocellular carcinoma (HCC) recurrence. However, there is no study on the relationship between the donor’s visceral adiposity and surgical outcomes in LDLT recipients. We investigated the association of the visceral-to-subcutaneous fat area ratio (VSR) in donors and recipients with HCC recurrence and mortality in LDLT.

Methods

We analyzed 1386 sets of donors and recipients who underwent LDLT between January 2008 and January 2018. The maximal chi-square method was used to determine the optimal cutoff values for VSR for predicting overall HCC recurrence and mortality. Cox regression analyses were performed to evaluate the association of donor VSR and recipient VSR with overall HCC recurrence and mortality in recipients.

Results

The cutoff values of VSR was determined as 0.73 in males and 0.31 in females. High donor VSR was significantly associated with overall HCC recurrence (adjusted hazard ratio [HR]: 1.43, 95% confidence interval [CI]: 1.06–1.93, p = 0.019) and mortality (HR: 1.35, 95% CI: 1.03–1.76, p = 0.030). High recipient VSR was significantly associated with overall HCC recurrence (HR: 1.40, 95% CI: 1.04–1.88, p = 0.027) and mortality (HR: 1.50, 95% CI: 1.14–1.96, p = 0.003).

Conclusions

Both recipient VSR and donor VSR were significant risk factors for HCC recurrence and mortality in LDLT recipients. Preoperative donor VSR and recipient VSR may be strong predictors of the surgical outcomes of LDLT recipients with HCC.

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Fig. 1
Fig. 2: Kaplan–Meier curves for overall HCC recurrence and mortality.

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Data availability

The dataset used and/or analyzed during the current study is available from the corresponding author upon reasonable request.

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Acknowledgements

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HR20C0026), and was supported by Institute of Information & communications Technology Planning & Evaluation (IITP) grant funded by the Korea government (MSIT, Project No. 2021-0-00393). This study was also supported by a grant (2022IP0053) from the Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea).

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Authors and Affiliations

  1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

    Ji-Hoon Sim, Young-Jin Moon, Hye-Mee Kwon, In-Gu Jun, Sung-Hoon Kim, Kyoung-Sun Kim, Jun-Gol Song & Gyu-Sam Hwang

  2. Department of Radiology, Asan Image Metrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea

    Kyung-Won Kim & YouSun Ko

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Contributions

JHS and JGS conceived and designed the study; JHS, KYK, YSK, HMK, YJM, IGJ, SHK, and JGS were involved in data acquisition; JHS, HMK, IGJ, and GSH were involved in the analysis and/or interpretation of data; JHS drafted the manuscript; JGS revised the manuscript critically for important intellectual content. All authors gave approval for the final manuscript.

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Correspondence to Jun-Gol Song.

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The authors declare no competing interests.

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The institutional review board of Asan Medical Center (Protocol No. 2021-0526) approved this study. The need for informed consent from individual patients was waived owing to the retrospective nature of the study.

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Sim, JH., Kim, KW., Ko, Y. et al. Association between visceral obesity and tumor recurrence in hepatocellular carcinoma recipients undergoing liver transplantation. Int J Obes 47, 1214–1223 (2023). https://doi.org/10.1038/s41366-023-01367-5

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