Prognostic impact of subcutaneous fat quality and sarcopenia on the survival outcomes in patients with colorectal cancer

Purpose: This study aimed to evaluate the relationship between the quantity and quality of subcutaneous fat and prognosis following colorectal cancer resection. Method: We conducted a retrospective analysis of the clinical data of 399 patients who underwent curative resection for stage 2 or 3 colorectal cancer between January 2013 and March 2019. This study examined the correlation between sarcopenia and various fat parameters, including fat area and density, and assessed their impact on the prognosis. Results: Sarcopenia was associated with a lower subcutaneous and visceral fat area, higher Hounsfield unit value in subcutaneous fat, and reduced modified intramuscular adipose tissue content in the multifidus, erector spinae, and psoas muscles. A low modified intramuscular adipose tissue content in the multifidus and erector spinae muscles was an independent prognostic factor for overall survival (hazard ratio, 2.28; p = 0.0329) and recurrence-free survival (hazard ratio: 2.32, p = 0.0233). Additionally, subcutaneous fat with a high Hounsfield unit was an independent predictor of a recurrence-free survival (hazard ratio, 2.68; p = 0.0142). Conclusion: Subcutaneous fat quality is correlated with sarcopenia and it thus serves as a prognostic factor for recurrence after stage 2 or 3 colorectal cancer resection.