The preoperative main body composition scoring system as a strong predictor of colorectal liver metastases

The three main components of body composition: skeletal muscle, adipose tissue, and bone, have been associated with cancer outcomes individually, but an integrative assessment combining all three has not been carried out. We aimed to establish a body composition scoring system incorporating all three components to stratify prognosis following hepatic resection for colorectal liver metastases (CRLM).

The subjects of this retrospective study were 164 patients who underwent hepatic resection for CRLM. The skeletal muscle index (SMI), fat area, and bone mineral density (BMD) were quantified using preoperative computed tomography (CT). A main body composition score (0-3) was developed by assigning 1 point for each high-value component. Patients were stratified into three groups according to their score: low (0), medium (1), and high (2-3).

The main body composition score correlated significantly with disease-free survival and overall survival (OS). The 5-year OS rate was 27.1% in the low-score group, 62.1% in the medium-score group, and 70.6% in the high-score group (p < 0.01). In the multivariable analysis, a low main body composition score predicted poor OS independently (hazard ratio, 3.18; 95% confidence interval, 1.68-6.03; p < 0.01).

The main body composition score, incorporating the SMI, fat area, and BMD, effectively stratified the survival outcomes of patients undergoing hepatic resection for CRLM.