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Purpose <p>To investigate body composition as a predictive biomarker of cancer-related death in patients with non-metastatic colon cancer (CRC).</p> Materials and methods <p>Patients with CRC (stages II–III) treated with upfront surgery, with availability of baseline CT, clinico-histological and survival data were retrospectively enrolled. Patients with stage IV or CT unavailability were excluded. Body composition parameters derived from baseline abdominal CT using AI-based automatic segmentation software. Seventy-six parameters regarding adipose visceral fat(AVF), subcutaneous fat(SF), bone density, liver density, and fat-fraction were automatically extracted from both whole segmentation volume and multislices region. According to the CRC-related death (CRC-related death), the population was divided into Group 1 (CRC-related death) and Group 2 (non-CRC-related death). Body composition features were compared between two groups. Predictive model and survival analysis were performed with ROC curves, Cox regression, and Kaplan–Meier method. <i>P</i> &lt; 0.05 was considered significant.</p> Results <p>A total of 293 patients were included, 101/293(34.5%) with CRC-related deaths. MeanHU of AVF and SF resulted directly correlated with CRC-related death (<i>P</i> = 0.004 and HR = 1.03, <i>P</i> = 0.002 and HR = 1.04, respectively) for the multislice analysis. MeanHU of AVF resulted in direct correlation with CRC-related deaths, also for the volumetric analysis (<i>P</i> = 0.04 and HR = 1.02). In multivariable Cox regression analysis, Mean<Emphasis Type="Underline">HU</Emphasis> AVF was confirmed as an independent predictor of CRC-related death in both multislice and volumetric analyses. SF HU remained significant in multislice analysis. In Kaplan–Meier analysis, AVF and SF for the multislice analysis resulted statistically significant (<i>P</i> = 0.033 and &lt; 0.001, Chi-square = 4.56 and 11.7, respectively).</p> Conclusion <p>In conclusion, our study demonstrated that body composition metrics of visceral and subcutaneous fat were significantly associated with cancer-related death in non-metastatic CRC patients.</p>

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Body composition as a predictor of cancer-related death in colon cancer: an AI-based volumetric analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月20日

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  • Michela Polici,
  • Benedetta Masci,
  • Damiano Caruso,
  • Stefano Nardacci,
  • Lapo Nardoni,
  • Fiammetta Pacelli,
  • Marta Zerunian,
  • Domenico De Santis,
  • Paolo Mercantini,
  • Enrico Fiori,
  • Mariarita Tarallo,
  • Maria Ciolina,
  • Riccardo Ferrari,
  • Sang Joon Park,
  • Jong-Min Kim,
  • Marco Francone,
  • Andrea Laghi

摘要

Purpose

To investigate body composition as a predictive biomarker of cancer-related death in patients with non-metastatic colon cancer (CRC).

Materials and methods

Patients with CRC (stages II–III) treated with upfront surgery, with availability of baseline CT, clinico-histological and survival data were retrospectively enrolled. Patients with stage IV or CT unavailability were excluded. Body composition parameters derived from baseline abdominal CT using AI-based automatic segmentation software. Seventy-six parameters regarding adipose visceral fat(AVF), subcutaneous fat(SF), bone density, liver density, and fat-fraction were automatically extracted from both whole segmentation volume and multislices region. According to the CRC-related death (CRC-related death), the population was divided into Group 1 (CRC-related death) and Group 2 (non-CRC-related death). Body composition features were compared between two groups. Predictive model and survival analysis were performed with ROC curves, Cox regression, and Kaplan–Meier method. P < 0.05 was considered significant.

Results

A total of 293 patients were included, 101/293(34.5%) with CRC-related deaths. MeanHU of AVF and SF resulted directly correlated with CRC-related death (P = 0.004 and HR = 1.03, P = 0.002 and HR = 1.04, respectively) for the multislice analysis. MeanHU of AVF resulted in direct correlation with CRC-related deaths, also for the volumetric analysis (P = 0.04 and HR = 1.02). In multivariable Cox regression analysis, MeanHU AVF was confirmed as an independent predictor of CRC-related death in both multislice and volumetric analyses. SF HU remained significant in multislice analysis. In Kaplan–Meier analysis, AVF and SF for the multislice analysis resulted statistically significant (P = 0.033 and < 0.001, Chi-square = 4.56 and 11.7, respectively).

Conclusion

In conclusion, our study demonstrated that body composition metrics of visceral and subcutaneous fat were significantly associated with cancer-related death in non-metastatic CRC patients.