Prognostic value of the body composition parameters in patients with colorectal liver metastases undergoing intra-arterial treatment

Background: To investigate the impact of baseline and temporal changes of the CT-body compositions on survival in patients with colorectal liver metastases (CLRM) undergoing intra-arterial treatment. Research design and methods: A total of 146 patients with CLRM (mean age:59.98 ± 11.94, M/F:90/56) who underwent intra-arterial procedures between January-2012 and December-2022 were included. We determined the patient CT-body compositions by measuring at the level of L3 vertebrae on CT scans. The relationship between body composition and survival was evaluated using Kaplan–Meier survival curves, while factors affecting survival were investigated through univariate and multivariate Cox-regression analyses. Results: Patients with sarcopenia had significantly shorter PFS (median PFS: 2.37 vs. 5.67 months; p < 0.001) and OS (median OS:6.20 vs. 13.47 months; p < 0.001) compared with those without sarcopenia. Similarly, patients with myosteatosis showed shorter PFS (median PFS: 3.73 vs. 6.10 months; p = 0.036) and OS (median OS: 8.80 vs. 15.37 months; p < 0.001) compared to those without myosteatosis. However, there was no statistically significant association between subcutaneous/visceral adipose tissue and survival. Besides other clinical or laboratory parameters, sarcopenia (HR: 2.65, p = 0.006), myosteatosis (HR: 2.74, p = 0.001) and greater loss of skeletal muscle index (HR: 2.03, p = 0.037) were independently associated with decreased overall survival. Conclusions: Baseline sarcopenia, myosteatosis, and greater loss of skeletal muscle index are independent predictors of poor survival in patients with CRLM undergoing intra-arterial treatment.