Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy

Abstract The relationship between CT-based body composition parameters and chemoradiotherapy outcomes in patients with esophageal squamous cell carcinoma (ESCC) is unclear. This study aimed to clarify the predictive value of myosteatosis and subcutaneous adipose tissue area (SATA) in ESCC patients u...

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Main Authors: Ling Xiao, Yudi Liu, Xue Zhang, Xinyu Nie, Jiahua Lyu, Tao Li
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-14769-4
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author Ling Xiao
Yudi Liu
Xue Zhang
Xinyu Nie
Jiahua Lyu
Tao Li
author_facet Ling Xiao
Yudi Liu
Xue Zhang
Xinyu Nie
Jiahua Lyu
Tao Li
author_sort Ling Xiao
collection DOAJ
description Abstract The relationship between CT-based body composition parameters and chemoradiotherapy outcomes in patients with esophageal squamous cell carcinoma (ESCC) is unclear. This study aimed to clarify the predictive value of myosteatosis and subcutaneous adipose tissue area (SATA) in ESCC patients undergoing chemoradiotherapy. The study cohort consisted of 255 ESCC patients undergoing chemoradiotherapy between January 2012 and December 2018. Body composition parameters, such as mean muscle density in Hounsfield units (HU) and adipose tissue area at the third lumbar vertebra (L3) level, were quantified on CT scans. Hazard ratios were estimated to establish the relationship between pretreatment skeletal muscle density (preSMD) and adipose tissue area with the overall survival (OS) rate. Optimal stratification was utilized to set threshold values. Kaplan–Meier plots and Cox proportional hazards models were developed to analyze survival distributions. Among 255 ESCC patients who received chemoradiotherapy, the median survival time was 24.3 months (95% CI 20.33–33.8). Multivariate analysis revealed that tumor length (HR = 1.547; 95% CI 1.115–2.145; P = 0.009), clinical stage (HR = 5.696; 95% CI 2.053–15.798; P < 0.001), and preSMD (HR = 1.528; 95% CI 1.079–2.169; P = 0.017) were independent indicators for OS. Additionally, SATA emerged as an independent predictor of preSMD (HR = 0.991; 95% CI 0.986–0.996; P = 0.038). A nomogram integrating preSMD, pretreatment subcutaneous adipose tissue area (preSATA), and independent prognostic factors effectively predicts the prognosis of ESCC patients, supplementing the TNM staging system. The study suggests that a prognostic model combining preSMD and preSATA effectively predicts the prognosis of ESCC patients undergoing chemoradiotherapy.
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spelling doaj-art-97b3b485d67d4754b3170acc4458775f2025-08-24T11:19:02ZengNature PortfolioScientific Reports2045-23222025-08-0115111410.1038/s41598-025-14769-4Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapyLing Xiao0Yudi Liu1Xue Zhang2Xinyu Nie3Jiahua Lyu4Tao Li5School of Medicine, University of Electronic Science and Technology of ChinaSchool of Medicine, University of Electronic Science and Technology of ChinaSchool of Medicine, University of Electronic Science and Technology of ChinaDepartment of Radiation Oncology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of ChinaSchool of Medicine, University of Electronic Science and Technology of ChinaSchool of Medicine, University of Electronic Science and Technology of ChinaAbstract The relationship between CT-based body composition parameters and chemoradiotherapy outcomes in patients with esophageal squamous cell carcinoma (ESCC) is unclear. This study aimed to clarify the predictive value of myosteatosis and subcutaneous adipose tissue area (SATA) in ESCC patients undergoing chemoradiotherapy. The study cohort consisted of 255 ESCC patients undergoing chemoradiotherapy between January 2012 and December 2018. Body composition parameters, such as mean muscle density in Hounsfield units (HU) and adipose tissue area at the third lumbar vertebra (L3) level, were quantified on CT scans. Hazard ratios were estimated to establish the relationship between pretreatment skeletal muscle density (preSMD) and adipose tissue area with the overall survival (OS) rate. Optimal stratification was utilized to set threshold values. Kaplan–Meier plots and Cox proportional hazards models were developed to analyze survival distributions. Among 255 ESCC patients who received chemoradiotherapy, the median survival time was 24.3 months (95% CI 20.33–33.8). Multivariate analysis revealed that tumor length (HR = 1.547; 95% CI 1.115–2.145; P = 0.009), clinical stage (HR = 5.696; 95% CI 2.053–15.798; P < 0.001), and preSMD (HR = 1.528; 95% CI 1.079–2.169; P = 0.017) were independent indicators for OS. Additionally, SATA emerged as an independent predictor of preSMD (HR = 0.991; 95% CI 0.986–0.996; P = 0.038). A nomogram integrating preSMD, pretreatment subcutaneous adipose tissue area (preSATA), and independent prognostic factors effectively predicts the prognosis of ESCC patients, supplementing the TNM staging system. The study suggests that a prognostic model combining preSMD and preSATA effectively predicts the prognosis of ESCC patients undergoing chemoradiotherapy.https://doi.org/10.1038/s41598-025-14769-4Esophageal squamous cell carcinomaMyosteatosisSkeletal muscle densitySubcutaneous adipose tissue area
spellingShingle Ling Xiao
Yudi Liu
Xue Zhang
Xinyu Nie
Jiahua Lyu
Tao Li
Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
Scientific Reports
Esophageal squamous cell carcinoma
Myosteatosis
Skeletal muscle density
Subcutaneous adipose tissue area
title Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
title_full Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
title_fullStr Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
title_full_unstemmed Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
title_short Predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of ESCC patients undergoing chemoradiotherapy
title_sort predictive value of myosteatosis and subcutaneous adipose tissue on the prognosis of escc patients undergoing chemoradiotherapy
topic Esophageal squamous cell carcinoma
Myosteatosis
Skeletal muscle density
Subcutaneous adipose tissue area
url https://doi.org/10.1038/s41598-025-14769-4
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