Overall Body Composition and Sarcopenia Are Associated with Poor Liver Hypertrophy Following Portal Vein Embolization

Jason W. Denbo, Bradford J. Kim, Jean Nicolas Vauthey, Ching Wei Tzeng, Jingfei Ma, Steven Y. Huang, Yun S. Chun, Matthew H.G. Katz, Thomas A. Aloia

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Purpose: To explore whether body composition and/or sarcopenia are associated with liver hypertrophy following portal vein embolization (PVE) in patients with colorectal liver metastases (CLM). Methods: Patients with CLM who underwent right PVE prior to a planned right hepatectomy were identified from the institutional liver database from 2004 to 2014. Patients were excluded due to previous liver-directed therapy/hepatectomy, right PVE + segment IV embolization, or planned 2-stage hepatectomy. Advanced imaging software was used to measure body compartment volumes (cm2), which were standardized to height (m2) to create an index: skeletal muscle index (SMI), subcutaneous adipose index (SAI), and visceral adipose index (VAI). SMI, gender, and body mass index (BMI) were used to define sarcopenia. The main outcome of interest was hypertrophy of the future liver remnant (FLR) following PVE, which was reported as degree of hypertrophy (DH) and kinetic growth rate (KGR). Results: Patients were evenly divided into three KGR groups: lower third (KGR:0.7–2.0%), middle third (KGR:2.0–4.1%), and upper third (KGR:4.2–12.3%). Patients in the lower third KGR group had a lower VAI (31.0 vs 53.0 vs 54.5 cm2/m2, p = 0.042) and were more commonly sarcopenic (60%) compared to the upper third (20%, p = 0.025). Eighteen patients (40%) met criteria for sarcopenia. Sarcopenic patients had a lower VAI (29.1 vs 57.4 cm2/m2, p = 0.004), lesser degree of hypertrophy (8.3% vs 15.2%, p = 0.009), and lower KGR (2.0% vs 4.0%, p = 0.012). Conclusion: Sarcopenia and associated body composition indices are strongly associated with clinically relevant impaired liver regeneration, which may result in increased liver-specific complications following hepatectomy for CLM.

Original languageEnglish (US)
Pages (from-to)405-410
Number of pages6
JournalJournal of Gastrointestinal Surgery
Issue number2
StatePublished - Feb 2021


  • Complications
  • Hepatectomy
  • Liver regeneration
  • PVE
  • Skeletal muscle
  • Visceral adipose

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


Dive into the research topics of 'Overall Body Composition and Sarcopenia Are Associated with Poor Liver Hypertrophy Following Portal Vein Embolization'. Together they form a unique fingerprint.

Cite this