Impact of body composition on clinical outcomes in patients with hepatocellular carcinoma: A systematic review and meta-analysis.
Elisa Pinto, Brigida Barberio, Martina Gambato et al.
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In 30 seconds
This systematic review and meta-analysis examined associations between body composition and outcomes in patients with hepatocellular carcinoma (HCC), across curative, locoregional, systemic, and mixed treatment settings. It included 92 studies; a random-effects meta-analysis of 44 studies found sarcopenia associated with worse overall survival (pooled HR 1.85, 95% CI 1.75-1.94; I2=0%). The association was consistent across treatment strata. Sarcopenia also predicted recurrence after curative treatment (pooled HR 1.71, 95% CI 1.61-1.82; k=14).
Key findings
- Sarcopenia was associated with worse overall survival in the pooled analysis (HR 1.85, 95% CI 1.75-1.94; I2=0%).
- Pooled overall-survival associations were consistent across curative (HR 1.86), locoregional (HR 2.10), and systemic treatment (HR 1.71).
- After curative treatment, sarcopenia predicted recurrence (pooled HR 1.71, 95% CI 1.61-1.82; k=14).
- In systemic therapy, myosteatosis predicted mortality (HR 1.45-2.01), while visceral adiposity was associated with lower mortality (HR 0.56-0.66).
Why it matters
Body composition measures may add prognostic information across HCC treatment settings, with sarcopenia consistently associated with poorer survival and recurrence. The differing associations reported for visceral adiposity by treatment context also caution against interpreting body-composition features uniformly. These findings support attention to body composition as a prognostic factor, while measurement approaches remain insufficiently standardized.
What to keep in mind
The review reports a need for consensus on measurement standardization; included studies used different assessment methods, including CT/MRI and bioelectrical impedance analysis.