Preoperative prediction of early recurrence of HBV-related hepatocellular carcinoma (≤5 cm) by visceral adipose tissue index.

Background: This study aimed to investigate whether visceral adipose tissue index (VATI) is a significant risk factor for the early recurrence (ER) of HBV-related hepatocellular carcinoma (HCC) (≤5 cm) after hepatectomy.

Methods: The recruited cohort patients who were positive for hepatitis B virus, presented with surgically confirmed HCC (≤5 cm) from Army Medical University (internal training cohort:  = 192) and Chongqing Medical University (external validation group:  = 46). We measured VATI, subcutaneous adipose tissue index (SATI) computed tomography (CT). ER was defined as recurrence within 2 years after hepatectomy. The impact of parameters on outcome after hepatectomy for HCC was analyzed.

Results: Univariate analysis showed that alpha-fetoprotein levels ( = 0.044), body mass index (BMI) ( < 0.001), SATI ( < 0.001), and VATI ( < 0.001) were significantly different between ER and non-ER groups in internal training cohort. Multivariate analysis identified VATI as an independent risk factor for ER (odds ratio = 1.07, 95% confidence interval: 1.047-1.094,  < 0.001), with a AUC of 0.802, based on the cut-off value of VATI, which was divided into high risk (≥37.45 cm/m) and low risk (<37.45 cm/m) groups. The prognosis of low risk group was significantly higher than that of high risk group (< 0.001). The AUC value of VATI in external validation group was 0.854.

Conclusion: VATI was an independent risk factor for the ER, and higher VATI was closely related to poor outcomes after hepatectomy for HBV-related HCC (≤5 cm).