Background: Adipose tissue distribution has been increasingly recognized for its potential impact on clinical outcomes in colorectal cancer (CRC) patients. This study systematically reviews and analyzes the relationship between visceral and subcutaneous adiposity and patient survival outcomes in CRC.
Methods: A comprehensive literature search was conducted across multiple databases including MEDLINE, PubMed, Google Scholar, Embase, Cochrane Library, and Web of Science, covering publications up to October 2024. Studies were selected based on their examination of the association between adiposity metrics (visceral adipose tissue [VAT], subcutaneous adipose tissue [SAT], VAT/SAT ratio) and overall survival (OS) or disease-free survival (DFS) in CRC patients. Outcomes were measured using hazard ratios (HRs) derived from univariate or multivariate analyses. Meta-analyses were performed using RevMan, pooling hazard ratios with 95 % confidence intervals (CIs) using both fixed and random-effects models.
Results: A total of 22 studies encompassing 11,954 CRC patients were included in the analysis. The meta-analysis indicated that higher levels of SAT were significantly associated with longer OS (HR: 0.77, p < 0.05) and DFS (HR: 0.61, p < 0.05). In contrast, VAT showed no significant correlation with OS or DFS. No publication bias was detected in the correlation between VAT/SAT and survival outcomes.
Conclusions: The findings suggest that elevated subcutaneous adiposity is linked to improved OS and DFS in colorectal cancer patients. These insights highlight the prognostic significance of SAT over VAT in CRC. Further large-scale studies are warranted to corroborate these results and explore the underlying mechanisms.
Keywords: Colorectal cancer; Disease free survival; Overall survival; Subcutaneous adipose tissue; Visceral adipose tissue.
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