ArticleLa Radiologia medica2026
Body composition as a predictor of cancer-related death in colon cancer: an AI-based volumetric analysis.
Article in La Radiologia medica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate body composition as a predictive biomarker of cancer-related death in patients with non-metastatic colon cancer (CRC). MATERIALS AND
methodsPatients 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.
resultsA 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).
conclusionIn 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.
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