Background: To investigate the impact of baseline and temporal changes of the CT-body compositions on survival in patients with colorectal liver metastases (CLRM) undergoing intra-arterial treatment.
Research design and methods: A total of 146 patients with CLRM (mean age:59.98 ± 11.94, M/F:90/56) who underwent intra-arterial procedures between January-2012 and December-2022 were included. We determined the patient CT-body compositions by measuring at the level of L3 vertebrae on CT scans. The relationship between body composition and survival was evaluated using Kaplan-Meier survival curves, while factors affecting survival were investigated through univariate and multivariate Cox-regression analyses.
Results: Patients with sarcopenia had significantly shorter PFS (median PFS: 2.37 vs. 5.67 months; p < 0.001) and OS (median OS:6.20 vs. 13.47 months; p < 0.001) compared with those without sarcopenia. Similarly, patients with myosteatosis showed shorter PFS (median PFS: 3.73 vs. 6.10 months; p = 0.036) and OS (median OS: 8.80 vs. 15.37 months; p < 0.001) compared to those without myosteatosis. However, there was no statistically significant association between subcutaneous/visceral adipose tissue and survival. Besides other clinical or laboratory parameters, sarcopenia (HR: 2.65, p = 0.006), myosteatosis (HR: 2.74, p = 0.001) and greater loss of skeletal muscle index (HR: 2.03, p = 0.037) were independently associated with decreased overall survival.
Conclusions: Baseline sarcopenia, myosteatosis, and greater loss of skeletal muscle index are independent predictors of poor survival in patients with CRLM undergoing intra-arterial treatment.
Keywords: Prognostic factors; chemoembolization; colorectal cancer; myosteatosis; radioembolization; sarcopenia.