Myosteatosis Differentially Affects the Prognosis of Non-Metastatic Colon and Rectal Cancer Patients: An Exploratory Study

Abstract

Body composition performed by computed tomography (CT) impacts on cancer patients’ prognoses and responses to treatment. Myosteatosis has been related to overall survival (OS) and disease-specific survival in colorectal cancer (CRC); however, the independent impact of the association of myosteatosis with prognosis in colon cancer (CC) and rectal cancer (RC) is still unclear. CT was performed at the L3 level to assess body composition features in 227 patients with CRC. Clinical parameters were collected. Overall survival (OS) was the primary outcome, and the secondary outcome was disease-free survival (DFS). Skeletal muscle attenuation and intramuscular adipose tissue area were associated with DFS (p = 0.003 and p = 0.011, respectively) and OS (p < 0.001 and p < 0.001, respectively) in CC patients but not in RC patients. Only the skeletal muscle area was associated with better prognosis related to OS in RC patients (p = 0.009). When CC and RC were analyzed separately, myosteatosis influenced survival negatively in CC patients, worsening DFS survival (hazard ratio [HR], 2.70; 95% confidence interval [CI], 1.07–6.82; p = 0.035) and OS (HR, 5.76; 95% CI, 1.31–25.40; p = 0.021). By contrast, the presence of myosteatosis did not influence DFS (HR, 1.02; 95% CI, 0.52–2.03; p = 0.944) or OS (HR, 0.76; 95% CI, 0.33–1.77; p = 0.529) in RC patients. Our study revealed the interference of myosteatosis in the therapy and survival of patients with CC but not in those with RC, strengthening the value of grouping the two types of cancer in body composition analyses.

Examining variations in body composition among patients with colorectal cancer according to site and disease stage

“…It's noteworthy that the disparities observed in our study may have diverse impacts on prognosis. Supporting this hypothesis, previous research demonstrated that myosteatosis influenced the survival in patients with colon cancer but not in those with rectal cancer 19 , emphasizing the need to differentiate between the two when analyzing BC.…”

“…In our study, we found that 68.7% of patients with CRC had low SMD. Furthermore, a low SMD also points to worse general and CRC-specific mortality than those with a normal SMD 19,20,29 . It's noteworthy that the disparities observed in our study may have diverse impacts on prognosis.…”

“…Studies have reported an association between changes in adipose and muscle tissue with worse clinical outcomes in patients with CRC [19][20][21] . Low SM serves as a pivotal biomarker for unfavorable outcomes and constitutes a crucial component in the diagnosis of sarcopenia 22,23 .…”

The coexistence of myosteatosis and the creatinine/cystatin C ratio are determinants of outcomes in cholangiocarcinoma patients undergoing curative surgery

“…The software was used to quantify the skeletal muscle and adipose tissue content at the third lumbar vertebra level to evaluate sarcopenia and myosteatosis according to previously established parameters (15). Different specific Hounsfield unit (HU) thresholds were assigned for various tissues: -29 to +150 HU for skeletal muscle, -150 to -50 HU for visceral adipose tissue, and -190 to -30 HU for subcutaneous and intramuscular adipose tissue (16).…”

The Augural Interplay of Myosteatosis and Gamma-Glutamyltransferase in Patients Undergoing Comprehensive Surgical Intervention for Cholangiocarcinoma

“…The system parameters were calibrated with Houns eld unit (HU) attenuation values as follows: -190 to -30 HU for subcutaneous and intramuscular adipose tissue, -150 to 50 HU for visceral adipose tissue, and − 29 to + 150 HU for skeletal muscle (Fig. 1) [21]. The diagnostic parameters were formulated based on the patient's BMI: for patients with a BMI ≥ 25 kg/m², an SMI < 53 signi ed sarcopenia, and an SMA < 33 HU signi ed myosteatosis.…”