Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Hepatocellular carcinoma (HCC) represents about 90% of primary liver cancers, occurs primarly in patients with chronic liver disease with various etiologies and constitutes a major global health problem. The incidence of HCC increases progressively with advancing age in all populations, reaching a peak at 70 years. Timely diagnosis and early intervention are crucial in the management of patients with HCC. As curative treatment options for early-stage HCC including surgical resection and liver transplantation, radiofrequency thermo-ablation (RFTA) and trans-arterial chemoembolization (TACE) represent an effective therapeutic strategies for cirrhotic patients with hepatocellular carcinoma [1-2]. It has been proposed that body composition parameters, particularly skeletal muscle index (SMI), may predict HCC patients outcomes [3-6]. Few studies investigated the role of visceral adipose tissue index and subcutaneous adipose tissue index (VATI and SATI) on patients' outcomes, and no data are available on the effect of their post-treatment changes in patients with HCC [7-8]. All cirrhotic patients with HCC treated for the first time with TACE or RFTA from 2012 to 2021 were retrospectively enrolled. Early changes of body composition (SMI, SATI and VATI) were extrapolated from abdominal CT scan performed before and one-month after treatment and expressed as DELTA, following the formula: (one-month value- pre-procedure value)/elapsed time [9-10]. OS and probability of being transplanted were investigated with Fine-Gray multivariate competing risk analysis considering Liver Transplantation (LT) and HCC progression outside the LT criteria (up-to-seven criteria) as competitive risk events.