Post-nCRT mIMAC could serve as a predictor of prognosis in rectal cancer patients receiving chemoradiotherapy, with low post-nCRT mIMAC being an independent prognostic factor for poor overall survival and disease-free survival.
Key Findings
Results
Post-nCRT mIMAC was significantly lower than pre-nCRT mIMAC in rectal cancer patients undergoing neoadjuvant chemoradiotherapy.
The study cohort comprised 97 patients who had undergone nCRT for rectal cancer.
The difference between pre- and post-nCRT mIMAC was statistically significant (P = 0.001).
mIMAC (modified intramuscular adipose tissue content) was used as the measure of myosteatosis.
Results
Older age was significantly associated with low pre- and post-nCRT mIMAC values.
Older age was significantly associated with low pre-nCRT mIMAC (P = 0.002).
Older age was significantly associated with low post-nCRT mIMAC (P < 0.001).
This association was observed in both the pre-treatment and post-treatment settings.
Results
Low pre-nCRT mIMAC was significantly associated with the presence of clinical lymph node metastasis.
The association between low pre-nCRT mIMAC and clinical lymph node metastasis was statistically significant (P = 0.02).
This association was not observed for post-nCRT mIMAC.
Pre-nCRT mIMAC was not identified as an independent prognostic factor for overall survival or disease-free survival.
Results
Low post-nCRT mIMAC was an independent prognostic factor for poor overall survival and disease-free survival.
Low post-nCRT mIMAC was independently associated with poor overall survival (P = 0.008).
Low post-nCRT mIMAC was independently associated with poor disease-free survival (P = 0.009).
These findings were derived from multivariate analysis in 97 rectal cancer patients.
Results
Low post-nCRT mIMAC was significantly correlated with poor oncologic outcomes in rectal cancer patients without pathologically proven lymph node metastasis.
Low post-nCRT mIMAC was significantly correlated with poor overall survival in patients without pathologically proven lymph node metastasis (P = 0.04).
Low post-nCRT mIMAC was significantly correlated with poor disease-free survival in patients without pathologically proven lymph node metastasis (P = 0.03).
This subgroup analysis suggests post-nCRT mIMAC may provide prognostic information beyond standard pathological staging.
Kitajima T, Okugawa Y, Shimura T, Yamashita S, Imaoka H, Kawamura M, et al.. (2026). Myosteatosis and myopenia may predict oncologic outcomes in patients with rectal cancer receiving preoperative chemoradiotherapy.. Nutrition (Burbank, Los Angeles County, Calif.). https://doi.org/10.1016/j.nut.2026.113108