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To quantify the correlation between body composition measurements derived from abdominal CT and post-chemoembolization outcomes. This institutional review board–approved, single-center retrospective study was conducted at a single academic medical center between January 2014 and January 2022. Patients who underwent liver ablation for primary or metastatic disease were identified from an interventional radiology quality database (Hi-IQ). Patients with pre-TACE non-contrast abdominal CT scans within 12 months of the procedure were then selected for further evaluation. Density measurements were taken at the L3 vertebral level, encompassing criteria for sarcopenia, sarcopenic obesity, and myosteatosis. Associations with post-liver transarterial chemoembolization outcomes were quantified using Cox proportional hazard, Kaplan-Meier analysis, and student t-test (mean ± SD). The demographic profiles of the 94 patients under investigation are detailed in Table 153.1. The median interval between CT and TACE was 128 days (interquartile, 38–227 days). The median follow-up post-TACE was 23 months (interquartile, 11-45 months). 78/94 patients (83%) exhibited myosteatosis. 33/94 patients (35%) met criteria for sarcopenia. 7/33 (21%) patients with sarcopenia presented with sarcopenic obesity. The proportion of female patients within the sarcopenia group (10/33 30%) was significantly lower compared to those without sarcopenia (28/61 46%) (p < .01). Body Mass Index (BMI) was significantly lower among sarcopenic patients (26±4) compared to those without sarcopenia (30±6) (p< .001). There were no discernible differences in sarcopenia status based on age (p = 0.45), presence of cirrhosis (p = 0.3), diabetes (p = .67), or race/ethnicity (p= .08). There was no statistically significant variance in BMI observed in patients with myosteatosis (29±6) vs without (27±4) (p=0.45). The Hazard Ratio (HR) for mortality in sarcopenic patients was determined to be 1.2 (95% Confidence Interval: 1.0, 1.3; p=0.03) as compared to non-sarcopenic patients. Kaplan-Meier analysis demonstrated that patients with sarcopenia prior to TACE exhibited higher mortality rates (log-rank=0.04). The presence of sarcopenia, as determined through standard pre-transarterial chemoembolization (TACE) abdominal CT scans, is correlated with mortality following TACE.
Yazdanpanah et al. (Wed,) studied this question.