Myosteatosis is gathering attention as a feasible
indicator for
sarcopenia and increased risk of morbidity. However, the prognostic value of intramuscular adipose tissue content (
IMAC) as an assessment method for myosteatosis remains controversial. The objectives of this study are to compare the prognostic value of intramuscular adipose tissue content (
IMAC) with our newly-developed modified
IMAC (
mIMAC), and to assess the clinical significance of
mIMAC in
colorectal cancer (CRC) and
gastric cancer (GC).
METHODS: Both preoperative
IMAC and
mIMAC were sex- and disease-dependent, and positively or negatively correlated with age in CRC and GC patients (
IMAC: CRC: r = 0.33, P < 0.0001; GC: r = 0.304, P < 0.0001;
mIMAC: CRC: r = -0.364, P < 0.0001; GC: r = -0.263, P < 0.0001). In contrast to
IMAC, lower preoperative
mIMAC was significantly associated with disease-development factors, and was an independent prognostic factor for both overall survival (OS) and disease-free survival (DFS) in both CRC (OS: hazard ratio (HR): 1.95, 95% confidence interval (CI): 1.25-3.03, p = 0.003; DFS: HR: 1.93, 95% CI: 1.22-3.04, p = 0.005) and GC patients (OS: HR: 2.11, 95% CI: 1.22-3.68, P = 0.008; DFS: HR: 2.03, 95% CI: 1.18-3.5, P = 0.011). Patients with postoperative remote
infections had a poorer prognosis compared with those without in both cohorts (CRC: HR: 2.67, 95% CI: 1.46-4.89, P = 0.002; GC: HR: 3.01, 95% CI: 1.47-6.19, P = 0.003), and low
mIMAC was an independent risk factor for postoperative remote
infection in both
cancers (CRC: odds ratio (OR): 2.56, 95% CI: 1.06-6.23, P = 0.038; GC: OR: 2.8, 95% CI: 1.03-7.58, P = 0.043). Finally, we assessed the correlation between
IMAC or
mIMAC and the representative
frailty markers body mass index (BMI),
serum albumin, and prognostic nutritional index (PNI). We found a positive correlation between preoperative
mIMAC and all of these markers in both cohorts (CRC: BMI: r = 0.193, P < 0.0001;
serum albumin: r = 0.42, P < 0.0001; PNI: r = 0.39, P < 0.0001; GC: BMI: r = 0.22, P < 0.0001;
serum albumin: r = 0.212, P < 0.0001; PNI: r = 0.287, P < 0.0001).
CONCLUSIONS: