Association Between Visceral Fat Area and Cancer Prognosis: A Population-Based Multicenter Prospective Study

Li, Lingyu; Li, Wenqian; Xu, Dongsheng; He, Hua; Wang, Yang; Guo, Hanfei; Liu, XiangLiang; Ji, Wei; Song, Chunhua; Xu, Hongxia; Li, Wei; Shi, Hanping; Cui, Jiuwei

doi:10.1016/j.ajcnut.2023.07.001

Cited by 12 publications

(2 citation statements)

References 49 publications

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“… 39 Some authors think that this effect could be explained by visceral obesity 40 as visceral adipose tissue appears to be a prognostic parameter for several cancers, including lung cancer. 41 However, the prognostic value of visceral adipose tissue seems to be observed for patients with lung cancers treated with chemotherapy 42 and not for those treated with immunotherapy. 43 44 In the case of immunotherapy, a team observed recently in a population of 52 patients with NSCLC treated with ICIs that low ‘lumbar skeletal muscle index’ and low ‘subcutaneous fat index’ were predictive of inferior OS.…”

Section: Discussionmentioning

confidence: 99%

Synergic prognostic value of 3D CT scan subcutaneous fat and muscle masses for immunotherapy-treated cancer

Decazes,

Ammari,

Belkouchi

et al. 2023

J Immunother Cancer

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BackgroundOur aim was to explore the prognostic value of anthropometric parameters in a large population of patients treated with immunotherapy.MethodsWe retrospectively included 623 patients with advanced non-small cell lung cancer (NSCLC) (n=318) or melanoma (n=305) treated by an immune-checkpoint-inhibitor having a pretreatment (thorax-)abdomen-pelvis CT scan. An external validation cohort of 55 patients with NSCLC was used. Anthropometric parameters were measured three-dimensionally (3D) by a deep learning software (Anthropometer3DNet) allowing an automatic multislice measurement of lean body mass, fat body mass (FBM), muscle body mass (MBM), visceral fat mass (VFM) and sub-cutaneous fat mass (SFM). Body mass index (BMI) and weight loss (WL) were also retrieved. Receiver operator characteristic (ROC) curve analysis was performed and overall survival was calculated using Kaplan-Meier (KM) curve and Cox regression analysis.ResultsIn the overall cohort, 1-year mortality rate was 0.496 (95% CI: 0.457 to 0.537) for 309 events and 5-year mortality rate was 0.196 (95% CI: 0.165 to 0.233) for 477 events. In the univariate Kaplan-Meier analysis, prognosis was worse (p<0.001) for patients with low SFM (<3.95 kg/m2), low FBM (<3.26 kg/m2), low VFM (<0.91 kg/m2), low MBM (<5.85 kg/m2) and low BMI (<24.97 kg/m2). The same parameters were significant in the Cox univariate analysis (p<0.001) and, in the multivariate stepwise Cox analysis, the significant parameters were MBM (p<0.0001), SFM (0.013) and WL (0.0003). In subanalyses according to the type of cancer, all body composition parameters were statistically significant for NSCLC in ROC, KM and Cox univariate analysis while, for melanoma, none of them, except MBM, was statistically significant. In multivariate Cox analysis, the significant parameters for NSCLC were MBM (HR=0.81, p=0.0002), SFM (HR=0.94, p=0.02) and WL (HR=1.06, p=0.004). For NSCLC, a KM analysis combining SFM and MBM was able to separate the population in three categories with the worse prognostic for the patients with both low SFM (<5.22 kg/m2) and MBM (<6.86 kg/m2) (p<0001). On the external validation cohort, combination of low SFM and low MBM was pejorative with 63% of mortality at 1 year versus 25% (p=0.0029).Conclusions3D measured low SFM and MBM are significant prognosis factors of NSCLC treated by immune checkpoint inhibitors and can be combined to improve the prognostic value.

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Section: Discussionmentioning

confidence: 99%

Synergic prognostic value of 3D CT scan subcutaneous fat and muscle masses for immunotherapy-treated cancer

Decazes,

Ammari,

Belkouchi

et al. 2023

J Immunother Cancer

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“…High intraperitoneal fat thickness has been linked to a reduced OS rate in patients with locally advanced gastric cancer, according to clinical trials ( 20 ). However, these results will need to be further confirmed in further studies, as there are few investigations on whether pre-operative intraperitoneal fat impacts the long-term survival of patients with stomach cancer following surgical operations ( 21 – 23 ).…”

Section: Introductionmentioning

confidence: 98%

Preoperative visceral fat index predicts the survival outcomes of patients with gastric cancer after surgery

Zuo,

Lin,

et al. 2024

Oncol Lett

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Visceral adipose tissue and skeletal muscle mass are associated with carcinogenesis and clinical outcomes in patients with cancer. The aim of the present study was to determine the influence of body composition parameters on postoperative survival in patients with gastric cancer. Demographic data and systemic inflammatory response data were obtained from patients with gastric cancer undergoing radical gastrectomy. The patient's skeletal muscle and visceral fat were assessed using computed tomography, and the corresponding skeletal muscle index (SMI) and visceral fat index (VFI) were calculated. Univariate and multivariate analyses were then performed. Of the 342 patients from whom information was collected, 125 of these patients eventually succumbed to the disease. A total of 271 (79.24%) of the patients were male and 71 (20.76%) were female. Regarding the entire cohort, the mean age was 64 years [interquartile range (IQR), 56–74 years], while the mean body mass index collected was 21.53 (IQR, 19.27–24.22). The median SMI and VFI of the patients were 47.73 (IQR, 41.67–55.51) and 41.28 (IQR, 36.62–45.36), respectively. It was concluded that a low SMI and VFI were associated with worse survival outcomes. However, the neutrophil-to-lymphocyte ratio and perioperative blood transfusion were not significantly associated with overall survival (OS). Among the indicators assessed, a low VFI was an independent risk factor associated with the worst OS time (hazard ratio 1.59; confidence interval, 1.03–2.45; P=0.038). Finally, a prognostic nomogram was constructed which included the VFI to assist clinicians in making more informed decisions. In conclusion, after data collection and analysis, it was found that there was a significant correlation between a low VFI and a shorter OS time in patients with gastric cancer following gastrectomy, suggesting that VFI may be a promising therapeutic target for postoperative interventions to improve patient survival further.

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LightGBM is an Effective Predictive Model for Postoperative Complications in Gastric Cancer: A Study Integrating Radiomics with Ensemble Learning

Wang,

Sheng,

Liao

et al. 2024

J Digit Imaging. Inform. med.

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Association Between Visceral Fat Area and Cancer Prognosis: A Population-Based Multicenter Prospective Study

Cited by 12 publications

References 49 publications

Synergic prognostic value of 3D CT scan subcutaneous fat and muscle masses for immunotherapy-treated cancer

Synergic prognostic value of 3D CT scan subcutaneous fat and muscle masses for immunotherapy-treated cancer

Preoperative visceral fat index predicts the survival outcomes of patients with gastric cancer after surgery

LightGBM is an Effective Predictive Model for Postoperative Complications in Gastric Cancer: A Study Integrating Radiomics with Ensemble Learning

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