Different prognostic impact of glucose uptake in visceral adipose tissue according to sex in patients with colorectal cancer

Abstract

The purpose of this study was to investigate whether sex differences in visceral fat volume and glucose uptake measured by positron emission tomography/computed tomography (PET/CT) in abdominal visceral fat can stratify overall survival (OS) in patients with colorectal cancer (CRC). We retrospectively enrolled 293 patients diagnosed with CRC who underwent PET/CT before surgical resection. Fluorodeoxyglucose uptake of visceral adipose tissue (VAT-SUV) and subcutaneous adiposity tissue (SAT-SUV) were measured using PET/CT. The relative VAT (rVAT) was defined as the visceral fat volume normalized to the total volume of fat (VAT plus SAT). We defined sex-specific cutoff values for VAT-SUV, SAT-SUV, and rVAT. Univariate and multivariate analyses using Cox proportional hazard regression analysis were performed to identify the independent prognostic factors. The study population comprised 181 men and 112 women. The rVAT (0.40 vs. 0.29, p < 0.001) and VAT-SUV (0.55 vs. 0.48, p = 0.007) were significantly greater in men than in women. High rVAT (than low rVAT) and high VAT-SUV (than low VAT-SUV) showed a worse prognosis in male and female patients, respectively. Multivariate analysis indicated that the combination of rVAT and VAT-SUV was an independent prognostic factor for predicting OS in both male and female patients. The combination of rVAT and VAT-SUV could differentiate the patients with the best survival outcome from the other three individual groups in female patients, but not in males. Glucose uptake and relative volume of visceral fat may provide a new risk stratification for patients with CRC, especially female patients.

Predicting the Recurrence of Gastric Cancer Using the Textural Features of Perigastric Adipose Tissue on [18F]FDG PET/CT

“…Since these morphological and functional modifications of adipocytes and inflammatory responses in the AT would bring qualitative changes in AT, a number of studies have tried to investigate whether the parameters of AT on diagnostic imaging examinations could represent these changes and could therefore be used as predictive factors for cancer progression [ 16 , 18 , 23 , 25 ]. On [ 18 F]FDG PET/CT, the mean SUV of visceral AT was proposed to be an imaging parameter that could reflect these qualitative changes in AT [ 16 , 18 , 23 , 26 , 27 ]. In previous studies, the mean SUV of visceral AT demonstrated significant positive associations with tumor stage and survival after treatments in patients with various intra-abdominal malignancies including colorectal cancer, gastric cancer, and pancreatic cancer [ 16 , 23 , 26 , 27 ].…”

“…On [ 18 F]FDG PET/CT, the mean SUV of visceral AT was proposed to be an imaging parameter that could reflect these qualitative changes in AT [ 16 , 18 , 23 , 26 , 27 ]. In previous studies, the mean SUV of visceral AT demonstrated significant positive associations with tumor stage and survival after treatments in patients with various intra-abdominal malignancies including colorectal cancer, gastric cancer, and pancreatic cancer [ 16 , 23 , 26 , 27 ]. In addition to the mean SUV, we also measured the first-order and second-order textural features of perigastric AT and evaluated the relationship between these imaging features and histopathological findings, which could provide a relevant basis for using textural features of perigastric AT as imaging biomarkers.…”

Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

“…There were 278 potentially eligible publications on post‐diagnosis adiposity and colorectal cancer outcomes. We excluded 193 publications 45–237 due to specific reasons related to the synthesis (Supplementary Table 5). Finally, 85 publications…”

Exploring the Influence of Age, Gender and Body Mass Index on Colorectal Cancer Location

“…Moreover, the presence of lymphovascular invasion and a high–high combination of rVAT and VAT-SUV were additionally significant for males. For females, any combination involving a high component of rVAT and/or VAT-SUV increased the risk of a poor OS [ 20 ].…”