2026-10-06T14:15:51Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33770875 2026-09-15T04:28:07Z category_388 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Preoperative CT-derived liver fat fraction and visceral adipose tissue index enhance postoperative recurrence risk stratification in colorectal cancer.docx Ke Yin (2027935) Mei Wei (324477) Wenjuan Ba (24912055) Rongyu Zhou (24912058) Bo Xiao (347938) Oncology and Carcinogenesis not elsewhere classified colorectal cancer computed tomography liver fat fraction recurrence-free survival nomogram postoperative recurrence visceral adipose tissue Background<p>Postoperative recurrence remains a major cause of treatment failure in colorectal cancer (CRC). We evaluated whether preoperative computed tomography (CT)-derived liver fat fraction (LFF) and visceral adipose tissue index (VATI) improve postoperative recurrence-risk prediction.</p>Methods<p>This multi-cohort study included 525 patients after curative-intent surgery: a training cohort (n=260), external validation cohort (n=208), and exploratory prospective cohort (n=57). Candidate clinicopathologic and CT-derived variables were evaluated using Cox regression. Performance was assessed with Harrell C-index, time-dependent area under the receiver operating characteristic curve (AUC) at 12 and 24 months, calibration, decision curve analysis, and Kaplan–Meier analysis.</p>Results<p>RFS events were observed in 129 patients. The final model included five predictors. N1–2 stage (hazard ratio [HR], 3.332; 95% confidence interval [CI], 1.807-6.145), elevated carbohydrate antigen 19-9 (CA19-9; HR, 2.414; 95% CI, 1.459-3.994), lymphovascular invasion (HR, 2.166; 95% CI, 1.250-3.752), VATI per 1-standard-deviation increase (HR, 1.519; 95% CI, 1.217-1.896), and LFF per 1-standard-deviation increase (HR, 2.228; 95% CI, 1.728-2.871) were independently associated with recurrence-free survival. C-indices were 0.851, 0.809, and 0.828 in the training, external, and prospective cohorts, respectively. Prospective 12- and 24-month AUCs were 0.759 (95% CI, 0.242-1.000) and 0.890 (95% CI, 0.709-1.000), with the latter based on only 20 evaluable patients. The combined validation cohort yielded a C-index of 0.813 and 12- and 24-month AUCs of 0.807 and 0.860.</p>Conclusion<p>CT-derived VATI and LFF improved risk stratification beyond routine clinicopathologic variables. The prospective findings remain exploratory and require confirmation in larger cohorts before clinical implementation.</p> 2026-09-15T04:28:07Z Dataset Dataset 10.3389/fonc.2026.1944392.s002 https://figshare.com/articles/dataset/Supplementary_file_1_Preoperative_CT-derived_liver_fat_fraction_and_visceral_adipose_tissue_index_enhance_postoperative_recurrence_risk_stratification_in_colorectal_cancer_docx/33770875 CC BY 4.0