{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:59:49Z","timestamp":1787673589527,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Visceral obesity (VO), associated with excessive visceral adipose tissue (VAT), has been extensively studied in cancer. However, whether low VAT can predict the prognosis of colorectal liver metastases (CRLM) undergoing neoadjuvant chemotherapy (NAC) remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicentre real\u2010world cohort study analysed data from initially resectable CRLM patients who received NAC. The predictive effect of VAT on progression\u2010free survival (PFS) and overall survival (OS) was evaluated using restricted cubic splines (RCS). VAT was categorized into low\/normal VAT and VO groups using X\u2010tile. The prognostic differences were further assessed through Kaplan\u2013Meier (KM) analysis. The impact of changes in VAT (\u0394VAT) after NAC was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1524 CRLM patients, 1105 patients (72.51%) were under 65\u2009years old, with a median VAT of 84.00 (36.24\u2013148.00) cm\n                      <jats:sup>2<\/jats:sup>\n                      . Of all patients, 804 (52.76%) were female. A U\u2010shaped nonlinear relationship was observed between VAT and both PFS\/OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Compared with the normal VAT, both low VAT and VO groups showed worsened PFS and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The 3\u2010year PFS rate was 31.6%, 69.0% and 42.0% in the low, normal VAT and VO groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). The 3\u2010year OS rate was 76.4%, 88.9% and 79.4% in the low, normal VAT and VO groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). There was also a nonlinear relationship between VAT and NAC\u2010related adverse events, objective response rate and postoperative complications (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). An increase in \u0394VAT in the low VAT group was associated with better PFS and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In the VO group, both increases and decreases in \u0394VAT were associated with worsened PFS and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study is the first to reveal that low VAT and VO can predict PFS and OS in CRLM patients undergoing NAC. Baseline VAT and \u0394VAT may serve as important indicators for risk stratification and personalized treatment in CRLM patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.13785","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T23:35:20Z","timestamp":1743723320000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Low Visceral Adipose Tissue Predicts the Outcome of Neoadjuvant Chemotherapy for Colorectal Liver Metastases: A Multicentre Real\u2010World Study"],"prefix":"10.1002","volume":"16","author":[{"given":"Yizhen","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital  Fuzhou Fujian 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Hepatobiliary Pancreatic Surgery The First Hospital of PuTian City  Putian Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital  Fuzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Geriatric Medicine, Fujian Key Laboratory of Geriatrics Diseases, Fujian Provincial Center for Geriatrics, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University Fuzhou University Affiliated Provincial Hospital  Fuzhou Fujian 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