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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1421651
This article is part of the Research Topic Newest Challenges and Advances in the Treatment of Colorectal Disorders; From Predictive Biomarkers to Minimally Invasive Techniques View all 21 articles

Different impacts of adipose tissue dynamics on prognosis in patients with resectable locally advanced rectal cancer treated with and without neoadjuvant treatment

Provisionally accepted
Huang Weiyan Huang Weiyan 1,2Jianqiang Chen Jianqiang Chen 2,3*Pengfei Rong Pengfei Rong 1*Zhichao Feng Zhichao Feng 1Mentian Ma Mentian Ma 1Fulong Song Fulong Song 1*Shumin Zeng Shumin Zeng 1*Fang Shao Fang Shao 1Xiaoping Yu Xiaoping Yu 4
  • 1 Department of Radiology, The Third Xiangya Hospital of Central South University,, Changsha, Anhui Province, China
  • 2 Department of Radiology, Xiangya Haikou Hospital of Central South University, Haikou, Hainan Province, China
  • 3 Department of Radiology, The First Affiliated Hospital of Hainan Medical University,, Haikou, Hainan Province, China
  • 4 Hunan Cancer Hospital, Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China

The final, formatted version of the article will be published soon.

    Background: Body composition is recognized to be associated with clinical outcomes in patients with locally advanced rectal cancer (LARC). This study aimed to determine the prognostic role of regional adipose tissue distribution in patients with resectable LARC treated with or without neoadjuvant chemoradiotherapy (nCRT). Methods: This retrospective study included 281 consecutive patients who underwent radical surgery for LARC with or without preoperative nCRT between 2013 and 2019. Patients underwent contrast-enhanced CT scans before nCRT and before surgery. Visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (aSAT), and gluteal subcutaneous adipose tissue (gSAT) were quantified on the CT images. The association of adipose tissue distribution with progression-free survival (PFS) was analyzed using Cox proportional hazards analysis.Results: A total of 102 nCRT-treated and 179 primarily resected patients were included. During a median follow-up period of 24 months, 74 (26.3%) patients experienced local recurrence or metastasis. Multivariable analysis showed that VAT was associated with PFS in all patients (hazard ratio [HR] 1.28, 95% confidence interval [CI] 1.04-1.57; P = 0.021). This association was only maintained in primarily resected patients (HR 1.31, 95% CI 1.02-1.69; P = 0.037). For patients receiving preoperative nCRT, VAT was not significantly associated with PFS, while the dynamic change in gSAT (ΔgSAT) between nCRT and surgery was associated with PFS (HR 0.43, 95%CI 0.27-0.69, P = 0.001).Visceral obesity is an adverse prognostic factor in patients with resectable LARC treated by primary resection, while increased gluteal subcutaneous adiposity during preoperative nCRT may indicate favorable clinical outcomes.

    Keywords: Locally advanced rectal cancer, Neoadjuvant chemoradiotherapy, Adipose Tissue, prognosis, computed tomography

    Received: 02 May 2024; Accepted: 09 Jul 2024.

    Copyright: © 2024 Weiyan, Chen, Rong, Feng, Ma, Song, Zeng, Shao and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jianqiang Chen, Department of Radiology, Xiangya Haikou Hospital of Central South University, Haikou, Hainan Province, China
    Pengfei Rong, Department of Radiology, The Third Xiangya Hospital of Central South University,, Changsha, Anhui Province, China
    Fulong Song, Department of Radiology, The Third Xiangya Hospital of Central South University,, Changsha, Anhui Province, China
    Shumin Zeng, Department of Radiology, The Third Xiangya Hospital of Central South University,, Changsha, Anhui Province, China

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