Impact of altered body composition on clinical and oncological outcome in intrahepatic cholangiocarcinoma

Introduction Intrahepatic cholangiocarcinoma is a common primary liver tumor with limited treatment op-tions and poor prognosis. Changes in body composition (BC) have been shown to affect the prog-nosis of various types of tumors. Therefore, our study aimed to investigate the correlation be-tween BC and clinical and oncological outcomes in patients with iCCA.

Methods All patients with iCCA who had surgery from 2010 to 2022 at our institution were included. We used CT scans and 3D Slicer software to assess BC and conducted logistic regressions as well as cox regressions and Kaplan-Meier analysis to investigate associations of BC to clinical variables with focus on post-operative complications and oncological outcome.

Results BC was frequently altered in iCCA (n=162) with 53.1% of the patients showing obesity, 63.2% sarcopenia, 52.8% myosteatosis ,10.1% viscer-al obesity and 15.3% sarcopenic obesity. Multivariate analysis showed no meaningful associa-tion between BC and perioperative complications. Myosteatosis was associated with reduced overall survival (OS) in iCCA patients (myosteatosis vs. non-myosteatosis, 7 vs. 18 months, p=0.016 log rank). Further, subgroup analysis revealed a notable effect in the subset of R0 resected patients (myosteatosis vs. non-myosteatosis, 18 vs. 32 months, p=0.025) and patients with nodal metastases (myosteatosis vs. non-myosteatosis, 7 vs. 18 months, p=0.016).

Conclusion While altered BC is not associated with perioperative outcomes in iCCA, myosteatosis emerges as a prognostic factor for reduced OS in the overall and sub-populations of resected patients.

Publication History

Article published online:
23 January 2024