Association between CT-Quantified Body Composition and Recurrence, Survival in Nonmetastasis Colorectal Cancer Patients Underwent Regular Chemotherapy after Surgery

BACKGROUND: Body mass index, measured at colorectal cancer (CRC) diagnosis has been associated with recurrence and survival outcomes. Computed tomography- (CT-) defined body compositions accurately reflect body mass, but there was no consistent perspective on the influence of visceral adipose tissue (VAT) and skeletal muscle mass (SM) on the prognosis of nonmetastasis CRC, especially in the patients underwent surgery and regularly standard chemotherapy. METHODS: We investigated the associations of CT-quantified body composition (VAT and SM) with CRC patients successively underwent surgery and regular 8-12 of periods standard chemotherapy. All of the CT images were obtained at the level of the L3/4 spinal level. The prognostic value of the body compositions was analyzed using the Cox regression model, and precise clinical nomograms were established. RESULTS: In XELOX-treated patients, progression-free survival (PFS) (P = 0.025) and overall survival (OS) (P = 0.032) were lower in the high-SM than in the low-SM group. The univariate analysis demonstrated that compared with low-SM patients, patients with high-SM showed a strikingly poor prognosis in both OS (P = 0.0512) and PFS in the T4 subgroup (P = 0.0417), while contrary to the T2-3 subgroup. CONCLUSIONS: CT-quantified body compositions have a significant influence on CRC patients successively underwent curative resection and regularly standard chemotherapy with the endpoints of 1-year, 3-year, and 5-year both OS and PFS. Patients with high-SM showed a strikingly poor prognosis in OS and PFS in the T4 subgroup; however, the prognosis role of body composition was opposite in T2-3 patients.