Higher visceral fat area/subcutaneous fat area ratio measured by computed tomography is associated with recurrence and poor survival in patients with mid and low rectal cancers

Lee, Kang Hong; Kang, Bo Kyeong; Ahn, Byung Kyu

doi:10.1007/s00384-018-3065-z

Cited by 23 publications

(25 citation statements)

References 12 publications

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“…PMI is a simple but reliable method of prognostic evaluation similar to SOFA. Body composition has recently been reported as a risk factor or prognostic factor for postoperative complications [3,5,24,25]. In particular, skeletal muscle mass is considered important [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Kayano

Nomura

Abe

et al. 2019

Preprint

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Background Various body composition indices have been reported as prognostic factors for different cancers. However, whether body composition affects prognosis after lower gastrointestinal tract perforation requiring emergency surgery and multidisciplinary treatment has not been clarified. This study examined whether body composition evaluations that can be measured easily and quickly from computed tomography (CT) are useful for predicting prognosis. Methods Subjects comprised 64 patients diagnosed with perforation at final diagnosis after emergency surgery for a preoperative diagnosis of lower gastrointestinal tract perforation and penetration. They were divided into a survival group and a non-survival (in-hospital mortality) group and compared. Body composition indices (psoas muscle index (PMI); psoas muscle attenuation (PMA); subcutaneous adipose tissue index (SATI); visceral adipose tissue index (VATI); visceral-to-subcutaneous fat area ratio (VSR)) were measured from preoperative CT. Cross-sectional psoas muscle area at the level of the 3rd lumbar vertebra was quantified. Optimal cut-off values were calculated using receiver operating characteristic curve analysis. Poor prognostic factors were investigated from multivariate logistic regression analyses that included patient factors, perioperative factors, intraoperative factors, and body composition indices as explanatory variables. Results The cause of perforation was malignant disease in 12 cases (18.7%), and benign disease in 52 cases (81.2%). The most common cause was diverticulum of the large intestine. Emergency surgery for the 64 patients led to survival in 52 patients and death in 12 patients. On multivariate logistic regression analysis, independent predictors of poor prognosis were Sequential Organ Failure Assessment score (odds ratio 1.908; 95% confidence interval (CI) 1.235–3.681; P =0.0020) and PMI (odds ratio 13.478; 95%CI 1.342–332.690; P =0.0252). The cut-off PMI was 4.75 cm 2 /m 2 for males and 2.89 cm 2 /m 2 for females. Among survivors, duration of hospitalization was significantly longer in the low PMI group (29 days) than in the high PMI group (22 days, p=0.0257). Conclusions PMI is easily determined from CT and allows rapid evaluation of prognosis following lower gastrointestinal perforation.

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Section: Discussionmentioning

confidence: 99%

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Kayano

Nomura

Abe

et al. 2019

Preprint

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“…Controversy still exists on the relationship between VATI and clinical outcomes in patients with solid tumors. [10,[22][23][24] The reasons whereby SATI appears to hold a stronger association with OS over VATI in our study remain to be elucidated. However, it is notable that-differently from visceral fat (which is an active endocrine organ)-subcutaneous fat is more strictly involved in lipid and energy storage and is characterized by a lower inflammatory environment [14,25,26].…”

Section: Discussionmentioning

confidence: 71%

Association of subcutaneous and visceral adipose tissue with overall survival in Taiwanese patients with bone metastases – results from a retrospective analysis of consecutively collected data

et al. 2020

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Background Growing evidence indicates that measures of body composition may be related to clinical outcomes in patients with malignancies. The aim of this study was to investigate whether measures of regional adiposity-including subcutaneous adipose tissue index (SATI) and visceral adipose tissue index (VATI)-can be associated with overall survival (OS) in Taiwanese patients with bone metastases. Methods This is a retrospective analysis of prospectively collected data. We examined 1280 patients with bone metastases who had undergone radiotherapy (RT) between March 2005 and August 2013. Body composition (SATI, VATI, and muscle index) was assessed by computed tomography at the third lumbar vertebra and normalized for patient height. Patients were divided into low-and high-adiposity groups (for both SATI and VATI) according to sexspecific median values.

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“…40 At present, VO is thought to be related to the incidence of postoperative complications and poor prognosis. [41][42][43][44] But this is a controversial view. 45,46 In our study, the patients were divided into four groups according to BMI.…”

Section: Discussionmentioning

confidence: 99%

<p>BMI May Be a Prognostic Factor for Local Advanced Rectal Cancer Patients Treated with Long-Term Neoadjuvant Chemoradiotherapy</p>

Liu¹,

Wei²,

Li³

et al. 2020

CMAR

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This study aims to develop feasible nomograms to predict the overall survival (OS) and cancer-specific survival (CSS) of the local advanced rectal cancer (LARC) patients who were treated with neoadjuvant chemoradiotherapy (nCRT) and operation. Methods: A total of 243 LARC patients undergoing nCRT followed by total mesorectal excision (TME) were enrolled. Preoperative clinical features and postoperative pathological characteristics were collected. A Cox regression analysis was performed, and Cox-based nomograms were developed to predict the OS and CSS. We assessed the predictive performance of the nomogram with concordance index and calibration plots. Results: A total of 243 patients were included with a median follow-up period of 46 months (range from 9 to 86 months). Cox regression analysis showed that low BMI (BMI < 18.5, HR= 21.739, P < 0.05), high level of preoperative CA19-9 (HR = 3.369, P = 0.036), high ypStage (HR = 19.768, P < 0.001), positive neural invasion (HR = 4.218, P = 0.026) and no adjuvant chemotherapy (HR = 5.495, P < 0.001) were independent predictors of poor OS. Age ≥70 (HR = 2.284, P <0.001), low BMI (BMI < 18.5, HR = 3.906, P < 0.05), positive preoperative CA19-9 (HR = 1.920, P = 0.012), high ypStage (HR = 5.147, P <0.001) and positive neural invasion (HR = 2.873, P = 0.022) were independent predictors of poor CSS. The predictive nomograms were developed to predict the OS and CSS with a C-index of 0.837 and 0.760. Good statistical performance on internal validation was shown by calibration plots. Conclusion: In conclusion, this study demonstrated that BMI was an independent prognostic factor for OS and CSS in LARC patients treated with nCRT followed TME. A nomogram incorporating BMI, neural invasion, pre-CA19-9, ypStage, age, and adjuvant chemotherapy could be helpful to predict the OS and CSS.

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Higher visceral fat area/subcutaneous fat area ratio measured by computed tomography is associated with recurrence and poor survival in patients with mid and low rectal cancers

Abstract: V/S ratio is the optimal obesity index for predicting stage I-III MLRC recurrence.

Cited by 23 publications

References 12 publications

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Low psoas muscle index is a poor prognostic factor for lower gastrointestinal perforation: a single-center retrospective cohort study

Association of subcutaneous and visceral adipose tissue with overall survival in Taiwanese patients with bone metastases – results from a retrospective analysis of consecutively collected data

<p>BMI May Be a Prognostic Factor for Local Advanced Rectal Cancer Patients Treated with Long-Term Neoadjuvant Chemoradiotherapy</p>

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