Subcutaneous Adipose Tissue Accumulation is Associated With an Improved Prognosis in Patients With Hepatocellular Carcinoma.

AIM: This study investigated the effects of the subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI) on the overall survival (OS) of patients with hepatocellular carcinoma (HCC).

METHODS

This study included 587 patients with HCC. The Cox proportional hazards model was used to identify independent prognostic factors. The optimal SATI cutoff value that yielded the most significant differences in OS was determined using the maximally selected statistics. Survival was estimated using the Kaplan-Meier method, and differences between survival curves were evaluated using the log-rank test.

RESULTS

SATI (hazard ratio, 0.99; 95% confidence interval, 0.98-0.99; p < 0.001) was significantly associated with improved OS after adjustment for potential confounders. The high-SATI group (≥ 41.1 cm2/m2 for males and ≥ 48.9 cm2/m2 for females) demonstrated significantly longer survival than those in the low-SATI group (p < 0.001; median survival: 87.0 vs. 40.4 months). The results of the decision tree analysis showed that patients with SATI ≥ 41.0 cm2/m2 who received curative treatment demonstrated the best survival (median survival: 191.8 months). Subgroup analyses revealed that the survival advantage of the high-SATI group was consistent across most subgroups, except for patients with metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease, body mass index > 25 kg/m2, VATI ≥ 85 cm2/m2, or hyperlipidemia.

CONCLUSIONS

In the absence of findings indicative of ectopic lipid accumulation, SAT accumulation is associated with an improved prognosis in patients with HCC.