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European Radiology
Published in: European Radiology 3/2019

01-03-2019 | Oncology

Quantitative assessment of mesorectal fat: new prognostic biomarker in patients with mid-to-lower rectal cancer

Authors: Jiyoung Yoon, Yong Eun Chung, Joon Seok Lim, Myeong-Jin Kim

Published in: European Radiology | Issue 3/2019

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Abstract

Objectives

To investigate the impact of mesorectal fat area (MFA) on oncologic outcomes in patients with mid-to-lower rectal cancer who received curative-intent surgery.

Methods

Patients with mid-to-lower rectal cancer who underwent preoperative abdominopelvic computed tomography (CT) and curative-intent surgery in 2011 were divided into two groups by tumour recurrence (group A) or no recurrence (group B) during a 5-year follow-up. Visceral fat area (VFA) and MFA were measured on preoperative CT and cutoff values were calculated using the Youden index. Univariate and multivariate regression analyses including BMI, VFA, and MFA were performed to investigate meaningful prognostic biomarkers. The Kaplan–Meier method with log-rank testing was used to validate prognostic biomarkers.

Results

Group A contained 42 patients and group B had 155 patients. Cutoff values were 25 kg/m2 for BMI, 130 cm2 for VFA, and 10 cm2 for MFA using the Youden index. On multivariate Cox regression analysis, MFA (odds ratio [OR] = 0.426, p = 0.010), TNM stage (p = 0.027), and perioperative complication grade (p = 0.028) were significantly different between groups. BMI and VFA did not show significant differences. By the Kaplan–Meier method with log-rank testing, disease-free survival (DFS) was significantly longer in patients with MFA ≥10 cm2 compared to patients with MFA <10 cm2 (p = 0.021), with no significant difference in overall survival (OS).

Conclusions

MFA was an independent biomarker for predicting DFS in patients who underwent curative-intent surgery for mid-to-lower rectal cancer.

Key Points

• Mesorectal fat area is associated with the prognosis of rectal cancer patients.
• Mesorectal fat area can be calculated easily in pre-operative CT scan.
• Predicting prognosis of the cancer patient before operation is important.
Appendix
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Metadata
Title
Quantitative assessment of mesorectal fat: new prognostic biomarker in patients with mid-to-lower rectal cancer
Authors
Jiyoung Yoon
Yong Eun Chung
Joon Seok Lim
Myeong-Jin Kim
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5723-5

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