PD691 - BODY FAT DENSITY AS A PROGNOSTIC MARKER IN COLORECTAL CANCER ADJUVANT THERAPY

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PD691

BODY FAT DENSITY AS A PROGNOSTIC MARKER IN COLORECTAL CANCER ADJUVANT THERAPY

W. Arantes Ferreira Peres1,*, J. Andre2, L. Murad2, P. Padilha1, L. Oliveira2

1Federal University of Rio de Janeiro, 2National Institute of cancer, Rio de Janeiro, Brazil

 

Rationale: Body mass index (BMI) inadequately reflects body composition and its prognostic implications in colorectal cancer (CRC). Adipose tissue radiodensity has emerged as a potential biomarker reflecting fat quality and metabolic reserves. This study aimed to evaluate the prognostic value of visceral (VATd) and subcutaneous (SATd) adipose tissue radiodensity in CRC patients undergoing adjuvant therapy.

Methods: This retrospective cohort study included 278 CRC patients treated between 2007 and 2015 at a cancer center. Body composition was assessed at the third lumbar vertebra. VATd and SATd were measured in Hounsfield units and categorized into tertiles. Clinical, pathological, and inflammatory variables, including the systemic inflammation response index (SIRI), were analyzed. Five-year overall survival (OS) was evaluated using Kaplan-Meier and Cox proportional hazards models.

Results: Stage III disease (HR 5.54, 95% CI 1.64-18.70), recurrence or metastasis (HR 4.16, 95% CI 2.39-7.24), and elevated SIRI (HR 2.42, 95% CI 1.55-3.76) were independently associated with worse OS. Conversely, the second VATd tertile (HR 0.43, 95% CI 0.22-0.84), adjuvant chemotherapy (HR 0.32, 95% CI 0.17-0.62), and chemoradiotherapy (HR 0.45, 95% CI 0.21-0.93) were independently associated with improved survival. Higher VATd and SATd tertiles attenuated the protective effect of adjuvant therapies, whereas intermediate SATd enhanced treatment-related survival benefits.

Conclusion: Adipose tissue radiodensity may represent an independent prognostic marker in CRC. Intermediate VATd and preserved subcutaneous fat are associated with improved survival and greater benefit from adjuvant therapy, highlighting the importance of body composition beyond BMI in oncologic risk stratification.

Disclosure of Interest: None declared