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Clinics and Research in Hepatology and Gastroenterology

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Visceral fat and clinical outcome in patients receiving first-line chemotherapy with bevacizumab for metastatic colorectal cancer - 26/05/24

Doi : 10.1016/j.clinre.2024.102380 
Nicolas Cazeneuve a, Olivier Bouché b, Julie Leger c, Christophe Borg d, Catherine Labbe-Devilliers e, Olivier Lucidarme f, Jean-Pierre Tasu g, Sylvain Manfredi h, Christophe Aubé i, Hervé Trillaud j, Philippe Manzoni k, Claude Marcus l, Eric Terrebonne m, Jean-Yves Douillard n, Romain Chautard o, p, Sarah Lobet p, Béatrice Scotto a, Aurore Bleuzen q, Thierry Lecomte o, p, ⁎
a Department of Radiology, Hôpital Trousseau, CHRU de Tours, 37044 Tours Cedex 09, France 
b Department of Hepatogastroenterology, Hôpital Robert Debré, CHU de Reims, avenue Général Koenig, 51092 Reims Cedex, France 
c INSERM CIC 1415, CHRU de Tours, CHRU de Tours, 37044 Tours Cedex 09, France 
d Department of Medical Oncology, Hôpital Jean Minjoz, CHRU de Besançon, 3 Boulevard Alexandre Fleming, 25000 Besançon, France 
e Department of Radiology, ICO René Gauducheau, 44805 Saint-Herblain, France 
f Department of Radiology, Hôpital Pitié-Salpétrière, APHP, 47, Boulevard de l'Hôpital, 75013 Paris, France 
g Department of Radiology, CHU de Poitiers, 2 rue Milétrie, 86021 Poitiers Cedex, France 
h Department of Hepatogastroenterology and Digestive Oncology, CHU de Rennes, Hôpital Pontchaillou, 2 rue Henri Le Guilloux, 35033 Rennes Cedex 9, France 
i Department of Radiology, CHU d'Angers, 4 rue Larrey 49100 Angers, France 
j Department of Diagnostic and Interventional Imaging, Hôpital Saint-André, CHU de Bordeaux, 1 rue Jean Burguet, 33000 Bordeaux, France 
k Department of Radiology, Hôpital Jean Minjoz, CHRU de Besançon, Hôpital Jean Minjoz, CHRU de Besançon, 3 Boulevard Alexandre Fleming, 25000 Besançon, France 
l Department of Radiology, Hôpital Robert Debré, CHU de Reims, avenue Général Koenig, 51092 Reims Cedex, France 
m Department of Hepatogastroenterology and Digestive Oncology, Hôpital du Haut Lêvèque, CHU de Bordeaux, avenue Magellan, 33604 Pessac Cedex, France 
n Department of Medical Oncology, ICO René Gauducheau, 44805 Saint-Herblain, France 
o Department of Hepatogastroenterology and Digestive Oncology, Hôpital Trousseau, CHRU de Tours, 37044 Tours Cedex 09, France 
p UMR INSERM U 1069, Université de Tours, 10 Boulevard Tonnellé, 37000 Tours, France 
q Department of Radiology, Hôpital Bretonneau, CHRU de Tours, CHRU de Tours, 37044 Tours Cedex 09, France 

⁎Corresponding author at: Pr. Thierry LECOMTE, Service d'Hépato-gastroentérologie et de Cancérologie digestive, Hôpital Trousseau, CHU de Tours 37044 Tours Cedex 09, France.Pr. Thierry LECOMTE, Service d'Hépato-gastroentérologie et de Cancérologie digestiveHôpital Trousseau, CHU de ToursTours Cedex 0937044France

Highlights

•
High visceral fat volume is associated with better outcome in patients receiving first-line bevacizumab-based chemotherapy for metastatic colorectal cancer.
•
Visceral adipose burden could play a critical role in pharmacodynamics of bevacizumab.
•
Fat mass evaluation might serve to provide information for predicting therapeutic efficacy to VEGF-targeted therapy in patient with metastatic colorectal cancer.

Il testo completo di questo articolo è disponibile in PDF.

Abstract

Background

Visceral fat produces angiogenic factors such as vascular endothelial growth factor that promote tumoral growth. However, its influence on outcome for patients with advanced cancer treated with anti-angiogenic agents is controversial.

Aims

The aim of this study was to determine whether visceral fat volume, visceral fat area and body mass index are associated with outcome in patients receiving first-line bevacizumab-based treatment for metastatic colorectal cancer.

Methods

This multicenter prospective study included 103 patients with metastatic colorectal cancer who received first-line bevacizumab-based chemotherapy. Computed tomography was used to measure visceral fat volume and visceral fat area. Endpoints were tumoral response at 2 months, progression free survival and overall survival.

Results

Visceral fat volume and visceral fat area, but not body mass index, were significantly associated with better outcome. Using sex-specific median values progression free survival was significantly longer in patients with high visceral fat volume (13.2 versus 9.4 months; p = 0.0043). In the same way, high visceral fat volume and visceral fat area were associated with a significantly better overall survival: 31.3 versus 20.5 months (p = 0.0072) and 29.3 versus 20.5 months (p = 0.0078), respectively. By multivariate analysis, visceral fat volume was associated with longer progression free survival and overall survival.

Conclusion

This study demonstrates that a high visceral fat volume is associated with better outcome in patients receiving first-line bevacizumab-based chemotherapy for metastatic colorectal cancer.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Colorectal cancer, Prognosis, VEGF, Bevacizumab, Visceral fat

Abbreviations : CRC, VEGF, VAT, BMI, VFA, VFV, CT, MRI, HU, TR, PFS, OS, CR, PR, SD, PD, WHO, CEA, IQR


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© 2024  The Authors. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 48 - N° 7

Articolo 102380- Agosto 2024 Ritorno al numero
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