{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:31:06Z","timestamp":1789475466736,"version":"build-2803163510"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To evaluate whether computed tomography (CT)-derived visceral adipose tissue index (VATI) is associated with synchronous metastasis and metastasis-free survival (MFS) after curative-intent surgery in colorectal cancer (CRC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective two-center study included patients with newly diagnosed CRC who underwent abdominal CT within 1 month before diagnosis or initial treatment between January 2019 and December 2022 (n = 468; metastatic CRC [mCRC], n = 77; non-metastatic CRC [nmCRC], n = 391). For the synchronous metastasis analysis, mCRC and nmCRC were propensity score matched 1:1 for age, sex, carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), study center, and tumor location (77 pairs), and multivariable logistic regression was performed. For the MFS analysis, the surgical nmCRC cohort was stratified by sex-specific median VATI into low-VATI (n = 195) and high-VATI (n = 196) groups, and Kaplan-Meier and Cox proportional hazards analyses were performed. Among patients who developed postoperative metastasis (n = 96), an exploratory descriptive comparison was performed between early (\u2264 2 years, n = 76) and late (&amp;gt; 2 years, n = 20) metastasis groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After matching, mCRC showed higher subcutaneous adipose tissue index (SATI), VATI, and visceral-to-subcutaneous fat area ratio (VSR) than nmCRC. VATI was independently associated with synchronous metastasis (OR, 1.110; 95% CI, 1.067\u20131.155; p &amp;lt; 0.001), whereas SATI and VSR were not. In the surgical nmCRC cohort, the high-VATI group had shorter MFS (log-rank p = 0.001). On multivariable Cox analysis, VATI remained independently associated with shorter MFS (HR, 1.017; 95% CI, 1.003-1.032; p = 0.021), together with CA19-9, CEA, N stage, and lymphovascular invasion (LVI). In the exploratory descriptive comparison, no statistically significant differences in body composition metrics were observed between the early and late metastasis groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative CT-derived VATI is a reproducible opportunistic imaging biomarker associated with synchronous metastasis and shorter MFS after curative-intent surgery and may help refine risk stratification and postoperative surveillance in CRC, although prospective validation is required before routine clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1830599","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:29:08Z","timestamp":1780374548000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of preoperative CT-derived visceral adipose tissue index with synchronous metastasis and metastasis-free survival after curative-intent surgery in colorectal cancer"],"prefix":"10.3389","volume":"16","author":[{"given":"Ke","family":"Yin","sequence":"first","affiliation":[{"name":"Department of Radiology, Bishan Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Chongqing Key Laboratory of Precision Medicine for Digestive System Tumors, Bishan Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuchen","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Bishan Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Gastroenterology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, 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