Body Composition and Survival in Locally Advanced Rectal Cancer Patients Treated with Neoadjuvant Radiochemotherapy

Area of Science:

• Oncology
• Radiotherapy
• Nutritional Science

Background:

• Nutritional status significantly influences treatment tolerance and clinical outcomes in cancer patients.
• Body composition assessment via computed tomography (CT) is crucial for evaluating oncological patient prognoses.
• Locally advanced rectal cancer (LARC) requires multimodal therapy, where nutritional status may play a key role.

Purpose of the Study:

• To assess body composition using CT scans in LARC patients undergoing multimodal therapy.
• To evaluate the association between body composition parameters and progression-free survival (PFS) and overall survival (OS).
• To analyze the correlation between dietary habits (nHDI-14) and survival outcomes in LARC patients.

Main Methods:

• Retrospective analysis of 216 LARC patients treated with neoadjuvant chemoradiotherapy (CRT).
• CT scans were used to measure visceral adipose tissue index (VATI) and subcutaneous adipose tissue index (SATI).
• Survival analyses (PFS and OS) were performed, alongside dietary data collection using the KomPAN® questionnaire to calculate the Non-Healthy-Diet-Index-14 (nHDI-14).

Main Results:

• Lower VATI and SATI were significantly associated with worse OS (p=0.0419 and p=0.0409, respectively).
• No significant association was found between VATI, SATI, and PFS, nor between skeletal muscle index (SMI), psoas muscle index (PMI), and PFS or OS.
• Sarcopenia development did not show a significant association with PFS or OS.

Conclusions:

• Reduced visceral and subcutaneous adipose tissue are significant predictors of poorer OS in LARC patients receiving multimodal treatment.
• Nutritional status, particularly adipose tissue levels, plays a critical role in the survival of LARC patients.
• The Non-Healthy-Diet-Index-14 (nHDI-14) showed a negative correlation with observation duration and patient age.