Prognostic Value of Body Fat Density in Colorectal Cancer Adjuvant Treatment: A Retrospective Cohort Study.

Stage III disease was independently associated with significantly reduced 5-year overall survival in colorectal cancer patients receiving adjuvant therapy.

• Hazard ratio of 5.54 (95% CI: 1.64–18.70) for Stage III disease compared to lower stages
• This was one of three factors independently associated with reduced survival in multivariate analysis
• Study design was a retrospective cohort with body composition quantified by computed tomography
• Primary endpoint was 5-year overall survival

Recurrence or metastasis was independently associated with reduced 5-year overall survival.

• Hazard ratio of 4.16 (95% CI: 2.39–7.24) for recurrence or metastasis
• This represented the second strongest predictor of reduced survival among the factors identified
• Finding derived from multivariate analysis of the retrospective cohort

Elevated systemic inflammation response index (SIRI) was independently associated with reduced 5-year overall survival.

• Hazard ratio of 2.42 (95% CI: 1.55–3.76) for elevated systemic inflammation response index
• SIRI was one of three factors independently predicting reduced survival
• Inflammation marker was assessed alongside body composition variables in the prognostic model

The second (intermediate) tertile of visceral adipose tissue radiodensity (VATd) was independently associated with improved 5-year overall survival.

• Hazard ratio of 0.56 (95% CI: 0.33–0.94) for the second VATd tertile
• Higher tertiles of VATd indicated lower fat proportion, while lower tertiles indicated higher fat proportion
• VATd was measured in Hounsfield units and categorized into tertiles
• Higher tertiles of VATd negatively impacted the beneficial prognosis of adjuvant therapy

Adjuvant chemotherapy and chemoradiotherapy were independently associated with improved 5-year overall survival.

• Adjuvant chemotherapy had a hazard ratio of 0.43 (95% CI: 0.22–0.84)
• Chemoradiotherapy had a hazard ratio of 0.45 (95% CI: 0.21–0.93)
• Both treatment modalities independently predicted improved outcomes in multivariate analysis

Patients with intermediate subcutaneous adipose tissue radiodensity (SATd) experienced stronger protective effects from adjuvant chemotherapy and chemoradiotherapy.

• Intermediate SATd with chemotherapy: HR 0.17 (95% CI: 0.06–0.49)
• Intermediate SATd with chemoradiotherapy: HR 0.26 (95% CI: 0.08–0.85)
• Higher tertiles of SATd negatively impacted the beneficial prognosis of adjuvant therapy
• SATd was measured in Hounsfield units and categorized into tertiles, with higher tertiles indicating lower fat proportion

Adipose tissue radiodensity of both visceral and subcutaneous compartments demonstrated prognostic value in colorectal cancer patients receiving adjuvant treatment.

• Body composition was quantified by computed tomography with both visceral (VATd) and subcutaneous (SATd) adipose tissue radiodensity measured in Hounsfield units
• Radiodensity was categorized into tertiles for analysis
• Intermediate VATd conferred survival advantage while elevated SATd attenuated treatment efficacy
• Study was a retrospective cohort design with primary endpoint of 5-year overall survival