• Atsushi Kobayashi, Toshimi Kaido, Yuhei Hamaguchi, Shinya Okumura, Hisaya Shirai, Naoko Kamo, Shintaro Yagi, Kojiro Taura, Hideaki Okajima, and Shinji Uemoto.
• Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
• World J Surg. 2018 Apr 1; 42 (4): 1180-1191.

ObjectivesWe have reported preoperative low skeletal muscularity as an independent risk factor for poor outcomes after liver transplantation, resection of hepatocellular carcinoma, pancreatic cancer and extrahepatic biliary malignancies. However, the impacts of visceral adiposity and muscularity on outcomes after liver resection for colorectal liver metastases (CLM) have not been fully investigated.MethodsWe retrospectively analyzed 124 patients undergoing primary liver resection for CLM between 2005 and 2014. Using preoperative computed tomography at the third lumbar vertebra level, skeletal muscle and abdominal adipose tissue were evaluated by skeletal muscle index (SMI), intramuscular adipose tissue content (IMAC) and visceral-to-subcutaneous adipose tissue area ratio (VSR), respectively. Impacts of preoperative SMI, IMAC and VSR on outcomes after liver resection for CLM were investigated.ResultsLow SMI and high VSR were not significantly associated with poor overall or recurrence-free survivals (P = 0.324 and P = 0.106, P = 0.964 and P = 0.738, respectively). Overall survival rate tended to be lower in patients with high IMAC than in patients with normal IMAC (P = 0.054). Recurrence-free survival rate did not differ significantly between high and normal IMAC (P = 0.721). Multivariate analysis showed that low SMI, high IMAC and high VSR were not significant risk factors for death or recurrence after liver resection for CLM.ConclusionNeither preoperative visceral adiposity nor low muscularity were poor prognostic factors in patients undergoing liver resection for CLM.

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