Visceral adipose tissue in predicting survival in patients with advanced colorectal cancer

Abstract Background The effect of adiposity on the prognosis of patients with colorectal cancer has long been controversial. This study intended to investigate the prognostic value of visceral adipose tissue in patients with advanced colorectal cancer, which accumulates within the abdominal cavity and acts as an endocrine organ. Methods Clinical data from 320 advanced colorectal cancer patients were collected. General characteristics and laboratory test results were gathered. Visceral fat area(VFA) and appendicular skeletal muscle mass were examined by bioelectrical impedance analysis. The restricted cubic spline was used to model the relationship between VFA and overall survival. The Kaplan-Meier curve was used to analyze the correlation between VFA and overall survival (OS). Spearman's analysis was used to explore the relationship between VFA and inflammatory indicators Results 185 males (57.8%) and 135(42.2%) females were conducted in this study. The restricted cubic spline showed higher VFA was associated with better prognosis in males, and the cut-off value was 83.41(p = 0.0006). After adjusting for weight and appendicular skeletal muscle (ASM), the cut-off values for VFA/weight and VFA/ASM were 1.22(p = 0.0004) and 3.71(p = 0.0002), respectively. The Kaplan–Meier curve showed the higher VFA group in males had a better prognosis(p < 0.0001). The median survival time was 43.73 months (95% confidence interval [CI]: 37.87–49.59) in the high VFA/weight group and 31.57 months (95% CI: 25.20-37.94) in the low VFA/weight group. The median survival time was 43.60 months (95% CI: 37.80–49.40) in the high VFA/ASM group and 31.57 months (95% confidence interval CI: 25.62–37.51) in the low VFA/ASM group. The VFA cut-off value in females was 88.11(p = 0.0407). However, there was no significant difference in prognosis between the high and low VFA groups for women. Analysis of the association between VFA and inflammatory factors showed a negative correlation between VFA and NLR, and the negative correlations between VFA/weight and VFA/ASM and NLR were even more pronounced (r=-0.54; r=-0.75). Conclusion Appropriate VFA range is associated with a favorable prognosis for patients with advanced colorectal cancer.