• Atsushi Kobayashi, Toshimi Kaido, Yuhei Hamaguchi, Shinya Okumura, Kojiro Taura, Etsuro Hatano, 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.
• J Hepatobiliary Pancreat Sci. 2016 Jan 1; 23 (1): 57-64.

BackgroundWe have reported that preoperative low skeletal muscle quality was an independent risk factor for poor outcomes after hepatectomy for hepatocellular carcinoma (HCC). However, postoperative changes of quality as well as quantity of skeletal muscle after hepatectomy for HCC and their impact on postoperative outcomes have not been fully investigated.MethodsWe retrospectively analyzed 241 patients undergoing primary hepatectomy for HCC between January 2007 and September 2012. The quality and quantity of skeletal muscle were evaluated by intramuscular adipose tissue content (IMAC) and the psoas muscle mass index (PMI) using computed tomography imaging at the umbilical level, respectively. We evaluated postoperative changes in IMAC and PMI in patients according to preoperative sarcopenia, sex, and surgical procedure. We also investigated the impact of ΔIMAC and ΔPMI on HCC recurrence in patients with preoperative normal IMAC.ResultsOn multivariate analysis, indocyanine green retention test at 15 min ≥ 15% (odds ratio [OR] = 3.156; P = 0.041) and high ΔIMAC at 6 months after hepatectomy (OR = 3.713; P = 0.024) were the risk factors for HCC recurrence in patients with preoperative normal IMAC.ConclusionPostoperative depletion of skeletal muscle quality is closely involved with HCC recurrence after hepatectomy for HCC.© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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