Cancer
Comparison of area and volumetric radiologically assessed body composition metrics with survival among colorectal cancer patients in the ColoCare Study Stephanie R. Hogue* Stephanie Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Hogue Non-Therapeutic Research Office, Moffitt Cancer Center
Body composition has been associated with colorectal cancer (CRC) survival but was largely characterized from CT scans with single slice area metrics. Multi-slice volumetric measures may better characterize total abdominal fat and muscle. We compared associations of area and volumetric measures with survival among CRC patients. We used Data Analysis Facilitation Suite to segment diagnostic CT scans and generate cross-sectional area at the axial mid-L3 vertebral level (cm2) and volume from the axial T12 vertebrae to the sacrum (cm3) metrics among 264 Moffitt CRC patients in the ColoCare cohort. All metrics [intermuscular (IMAT), visceral (VAT), and subcutaneous adipose tissue (SAT), plus skeletal muscle (SKM)] were indexed by dividing by height in m2. Proportional metrics were calculated (e.g., for VAT: VAT/[SAT+VAT+IMAT+SKM]) and transformed into sex-specific z-scores. We used multivariable Cox proportional hazards models to estimate associations of area and volumetric measures with overall [OS] and recurrence-free survival [RFS]. Participants were mostly men (56%) and had stage III CRC (50%). VAT was most strongly associated with survival versus IMAT, SAT, or SKM. Compared to VAT area at L3 (HR: 1.13, 95% CI:0.79-1.61), total VAT volumes from T12-Sacrum, T12-L3, and L3-Sacrum were more strongly associated with worse OS (HR: 1.25, 95% CI: 0.89, 1.77; HR: 1.21,95% CI:0.84, 1.74; and HR: 1.22, 95% CI:0.87, 1.72, respectively). A similar trend was observed for RFS (HR: 1.34, 95% CI: 0.95, 1.91 for L3; HR: 1.50, 95% CI: 1.08, 2.08; HR: 1.42, 95% CI: 1.01, 2.02; and HR: 1.49, 95% CI: 1.09, 2.03, respectively, for T12-Sacrum, T12-L3, and L3-Sacrum). Both single slice and volumetric VAT were associated with worse survival, though effect sizes were larger for volumetric measures, likely better reflecting inter-individual variability in adiposity across the abdominal cavity. Preliminary results will be expanded to include data from ColoCare sites across the US and Germany.