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

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...

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Main Authors: Yizhen Chen, Hangdong Jia, Rong Ye, Zhenyuan Zhou, Weijie Chen, Ming Zheng, Yuanyuan Zheng
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of Cachexia, Sarcopenia and Muscle
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Online Access:https://doi.org/10.1002/jcsm.13785
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author Yizhen Chen
Hangdong Jia
Rong Ye
Zhenyuan Zhou
Weijie Chen
Ming Zheng
Yuanyuan Zheng
author_facet Yizhen Chen
Hangdong Jia
Rong Ye
Zhenyuan Zhou
Weijie Chen
Ming Zheng
Yuanyuan Zheng
author_sort Yizhen Chen
collection DOAJ
description 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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spelling doaj-art-cce7eab4c68e489f83da4b88eec420b52025-08-20T02:35:37ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092025-04-01162n/an/a10.1002/jcsm.13785Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World StudyYizhen Chen0Hangdong Jia1Rong Ye2Zhenyuan Zhou3Weijie Chen4Ming Zheng5Yuanyuan Zheng6Department of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital Fuzhou Fujian ChinaGeneral Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital Hangzhou Medical College Hangzhou Zhejiang ChinaDepartment of Colorectal Surgery The First Affiliated Hospital of Fujian Medical University Fuzhou Fujian ChinaAnorectal Surgical Department Hangzhou Red Cross Hospital Hangzhou Zhejiang ChinaDepartment of Hepatobiliary Pancreatic Surgery The First Hospital of PuTian City Putian Fujian ChinaDepartment of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital Fuzhou Fujian ChinaDepartment of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital Fuzhou Fujian ChinaABSTRACT 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.https://doi.org/10.1002/jcsm.13785colorectal cancerliver metastasisneoadjuvant chemotherapyvisceral adipose tissuevisceral obesity
spellingShingle Yizhen Chen
Hangdong Jia
Rong Ye
Zhenyuan Zhou
Weijie Chen
Ming Zheng
Yuanyuan Zheng
Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
Journal of Cachexia, Sarcopenia and Muscle
colorectal cancer
liver metastasis
neoadjuvant chemotherapy
visceral adipose tissue
visceral obesity
title Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
title_full Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
title_fullStr Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
title_full_unstemmed Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
title_short Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real‐World Study
title_sort low visceral adipose tissue predicts the outcome of neoadjuvant chemotherapy for colorectal liver metastases a multicentre real world study
topic colorectal cancer
liver metastasis
neoadjuvant chemotherapy
visceral adipose tissue
visceral obesity
url https://doi.org/10.1002/jcsm.13785
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