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Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer

Authors
 Jin-Mok Kim  ;  Eric Chung  ;  Eun-Suk Cho  ;  Jae-Hoon Lee  ;  Su-Jin Shin  ;  Hye Sun Lee  ;  Eun Jung Park  ;  Seung Hyuk Baik  ;  Kang Young Lee  ;  Jeonghyun Kang 
Citation
 CLINICAL NUTRITION, Vol.40(11) : 5631-5638, 2021-11 
Journal Title
CLINICAL NUTRITION
ISSN
 0261-5614 
Issue Date
2021-11
Keywords
Colorectal cancer ; Subcutaneous fat ; Survival ; Visceral fat
Abstract
Background: Although different body composition including fat adiposity has known to be associated with survival in patients with colorectal cancer (CRC), the clinical significance was inconsistent. We investigated prognostic impact of visceral and subcutaneous fat adiposity in patients with CRC after surgical resection.

Material and methods: This retrospective single center study included 987 stage I-III CRC patients (583 males, and 404 females) who underwent surgical resection between March 2005 and April 2014. Preoperative diagnostic computed tomography images were used to quantify visceral fat area (VFA) and subcutaneous fat area (SFA). The sex-specific optimal cut-off value for body fat composition was defined using the X-tile program. The Cox proportional hazards model was used to determine the correlation fat composition and disease-free survival (DFS). Harrell's concordance index (C-index) and integrated area under curve (iAUC) were used to evaluate the predictive ability of cut-derived stratification.

Results: In univariate analysis, high SFA (≥141.73 cm2 in males and ≥168.71 cm2 in females) and high VFA (≥174.38 cm2 in male and ≥83.65 cm2 in female) were identified as significant prognostic factors for better DFS (p = .001 and p = .003 respectively). However, multivariate analysis revealed that high SFA independently predicted longer DFS (HR 0.505; 95% CI 0.266-0.957; p = .036) whereas, high VFA did not (HR 0.656; 95% CI 0.402-1.071; p = .092). Combining stage and SFA-cutoff showed better discriminatory performance than the model using stage solitary with respect to C-index (0.667; 95% CI 0.623-6.711; p = .0098) and iAUC (0.601; 95% CI 0.556-0.620).

Conclusion: High SFA was correlated with better DFS in patients with CRC. Subcutaneous fat can have additive predictive capability when incorporated into clinical decision-making.
Full Text
https://www.sciencedirect.com/science/article/pii/S0261561421004702
DOI
10.1016/j.clnu.2021.10.001
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kang, Jeonghyun(강정현) ORCID logo https://orcid.org/0000-0001-7311-6053
Park, Eun Jung(박은정) ORCID logo https://orcid.org/0000-0002-4559-2690
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Shin, Su Jin(신수진) ORCID logo https://orcid.org/0000-0001-9114-8438
Lee, Kang Young(이강영)
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0002-9898-9886
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Cho, Eun Suk(조은석)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/186973
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