Montano-Loza AJ, et al. - An analysis was performed to assess whether visceral adipose tissue (VAT) was correlated with the risk of hepatocellular carcinoma (HCC) in patients presenting with cirrhosis as well as HCC recurrence after liver transplantation (LT). Among male patients with cirrhosis, high VAT index (VATI) was a novel and independent risk factor for HCC, and for recurrence of HCC after LT.

• For body composition analysis, the clinicians assessed cirrhotic patients (n=678; 457 males) who were evaluated for LT (289 with HCC).
• They subsequently evaluated patients who underwent LT (n=247, 168 males) for body composition, and 96 of these patients (78 males) had HCC.
• They quantified VAT, subcutaneous (SAT) and total adipose tissues (TAT) by computed tomography at the level of the 3^rd lumbar vertebra and reported as indexes (cross-sectional area normalized for height [cm²/m²]).

• VAT index (VATI) was higher in male patients with HCC than the non-HCC patients (75±3 vs. 60±3 cm2/m2, P=0.001) at the time of LT assessment.
• In male patients with HCC, VATI, and SAT and TAT indexes were higher compared to non-HCC patients.
• Multivariate analysis showed that male patients with VATI ≥65 cm²/m2 had a higher risk of HCC (HR 1.90, 95% CI 1.31-2.76, P=0.001).
• A VATI ≥65 cm²/m2 adjusted for Milan criteria was independently associated with higher risk of HCC recurrence (HR 5.34, 95% CI 1.19-23.97, P=0.03) in male patients with HCC who underwent LT.