Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real-World Study

IF 9.4 1区医学 Q1 GERIATRICS & GERONTOLOGY

Journal of Cachexia Sarcopenia and Muscle Pub Date : 2025-04-01 DOI:10.1002/jcsm.13785

Yizhen Chen, Hangdong Jia, Rong Ye, Zhenyuan Zhou, Weijie Chen, Ming Zheng, Yuanyuan Zheng

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Abstract

Background

Visceral obesity (VO), associated with excessive visceral adipose tissue (VAT), has been extensively studied in cancer. However, whether low VAT can predict the prognosis of colorectal liver metastases (CRLM) undergoing neoadjuvant chemotherapy (NAC) remains unknown.

Methods

This multicentre real-world cohort study analysed data from initially resectable CRLM patients who received NAC. The predictive effect of VAT on progression-free survival (PFS) and overall survival (OS) was evaluated using restricted cubic splines (RCS). VAT was categorized into low/normal VAT and VO groups using X-tile. The prognostic differences were further assessed through Kaplan–Meier (KM) analysis. The impact of changes in VAT (ΔVAT) after NAC was evaluated.

Results

Among 1524 CRLM patients, 1105 patients (72.51%) were under 65 years old, with a median VAT of 84.00 (36.24–148.00) cm². Of all patients, 804 (52.76%) were female. A U-shaped nonlinear relationship was observed between VAT and both PFS/OS (p < 0.001). Compared with the normal VAT, both low VAT and VO groups showed worsened PFS and OS (p < 0.05). The 3-year PFS rate was 31.6%, 69.0% and 42.0% in the low, normal VAT and VO groups (p < 0.05). The 3-year OS rate was 76.4%, 88.9% and 79.4% in the low, normal VAT and VO groups (p < 0.05). There was also a nonlinear relationship between VAT and NAC-related adverse events, objective response rate and postoperative complications (p < 0.001). An increase in ΔVAT in the low VAT group was associated with better PFS and OS (p < 0.05). In the VO group, both increases and decreases in ΔVAT were associated with worsened PFS and OS (p < 0.05).

Conclusions

This study is the first to reveal that low VAT and VO can predict PFS and OS in CRLM patients undergoing NAC. Baseline VAT and ΔVAT may serve as important indicators for risk stratification and personalized treatment in CRLM patients.

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来源期刊

Journal of Cachexia Sarcopenia and Muscle MEDICINE, GENERAL & INTERNAL-

CiteScore

13.30

自引率

12.40%

发文量

234

审稿时长

16 weeks

期刊介绍： The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.