{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:38:26Z","timestamp":1790271506936,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022R1F1A1074811"],"award-info":[{"award-number":["2022R1F1A1074811"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Myosteatosis and liver steatosis (LS) have been recognized as patient\u2010derived image biomarkers that correlate with prognosis in colorectal cancer (CRC) patients. However, the significance of considering fat deposition in multiple body areas simultaneously has been underestimated. This study aimed to investigate the combined effect of myosteatosis and LS in stage I\u2010III CRC patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 616 stage I\u2010III CRC patients were included in the study. Myosteatosis was assessed using skeletal muscle radiodensity (SMD), and LS was estimated by calculating the Hounsfield unit of the liver and spleen ratio (LSR). Cox proportional hazard models were utilized to evaluate disease\u2010free survival (DFS). A combination of myosteatosis and LS was proposed, and its discriminatory performance was compared using the C\u2010index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 616 participants, the median (interquartile) age was 64 (55\u201372) years, and 240 (38.9%) were female. The median and interquartile range of LSR were determined as 1.106 (0.967\u20131.225). The optimal cutoff value for LSR was identified as 1.181, leading to the classification of patients into low (410, 66.5%) and high LSR (206, 33.4%) groups. Among the patients, 200 were categorized into the low SMD group, while 416 were allocated to the high SMD group. Both myosteatosis and LS were identified as independent prognostic factors in the multivariable analysis. The combination of these two variables resulted in a three\u2010group classification: high SMD with low LSR group, high SMD with high LSR group, and low SMD group. When comparing the C\u2010index values, the three\u2010group classification exhibited superior discriminatory performance compared with considering myosteatosis and LS separately.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Myosteatosis was associated with poorer survival, while the presence of LS was linked to a better prognosis in non\u2010metastatic CRC patients. Simultaneously considering fat infiltration can serve as a more effective prognosticator in non\u2010metastatic CRC patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13369","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T18:51:18Z","timestamp":1700074278000},"page":"2908-2915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Combined impact of myosteatosis and liver steatosis on prognosis in stage I\u2013III colorectal cancer patients"],"prefix":"10.1002","volume":"14","author":[{"given":"Dong Hee","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Il","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Sun","family":"Lee","sequence":"additional","affiliation":[{"name":"Biostatistics Collaboration Unit Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7311-6053","authenticated-orcid":false,"given":"Jeonghyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gangnam Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.31785"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2015.1131331"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.4143\/crt.2022.179"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00963"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2019.102839"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12723"},{"key":"e_1_2_8_9_1","first-page":"167","article-title":"Pathogenesis and prevention of hepatic steatosis","volume":"11","author":"Nassir F","year":"2015","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.631943"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhepr.2021.100323"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mri.2012.05.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-18-0125"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12330"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3156"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2017.06.024"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.45.2722"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216680245"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2020-321299"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2012.02.022"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i2.475"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.4254\/wjh.v10.i8.530"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.938718"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-07980-9"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-013-1656-2"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12007"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2022.11.002"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12899"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.13369","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T05:05:57Z","timestamp":1704949557000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.13369"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,15]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1002\/jcsm.13369"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.13369","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,15]]},"assertion":[{"value":"2023-06-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}