THE SLICE STUDY: THE PROGNOSTIC ROLE OF VISCERAL FAT IN METASTATIC COLORECTAL CANCER

Abstract

Overweight is an established risk factor of the colorectal cancer initiation and progression. Aim of this study is to investigate the prognostic role of visceral fat (VAT) in metastatic colorectal cancer (MCRC). We retrospectively analyzed 71 consecutive MCRC patients (2013-2017) at the Oncology Department of CRO Aviano (Italy). VAT area was measured as of cross-sectional area (cm2) at the L3 level divided by the square of the height (m2). A ROC analysis was performed to define a threshold capable to identify distinct prognostic categories of patients according to VAT. Subsequently, the value of VAT in predicting overall survival (OS) was evaluated with uni- and multivariate Cox regression analyses and estimated with Kaplan-Meier curves. Patients’ characteristics before first-line chemotherapy are reported in table 1. Interestingly, 40 pts (56%) had a body mass index (BMI)>25 and 42 (59%) had median VAT of 51.94. LDH level>=480 UI/L was recorded in 12 patients (27%) reflecting the inflammatory response. The optimal cut-off value for VAT was 44. Median OS was 30.97 months. At univariate analysis, older age (HR 2.46, p=0.013), primary tumor resection (HR 0.40, p=0.029), VAT>=44 (HR 2.85, p=0.011) and metastasectomy (HR 0.22, p=0.005), were significantly associated with OS (Table 2 and Figure1). By multivariate analysis, only VAT>=44 (HR2.64; p=0.030) was significantly associated with OS (Table 2). This exploratory study supported the prognostic role of VAT evaluation in patients with MCRC. In particular, high VAT was predictor of worse outcome. Further investigations are needed to confirm these preliminary data.