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

作者：Yizhen Chen, Hangdong Jia, Rong Ye, Zhenyuan Zhou, Weijie Chen, Ming Zheng, Zheng Yuanyuan · 发表于：Journal of Cachexia Sarcopenia and Muscle · 年份：2025 · DOI：10.1002/jcsm.13785 · 被引用次数：21 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment、Colorectal Cancer Screening and Detection

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: . 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...