{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:03:01Z","timestamp":1789448581114,"version":"build-2803163510"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"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>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats: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\u2013Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>RFS events were observed in 129 patients. The final model included five predictors. N1\u20132 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats: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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1944392","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:15Z","timestamp":1789446435000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative CT-derived liver fat fraction and visceral adipose tissue index enhance postoperative recurrence risk stratification 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"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Radiology, Bishan Hospital of Chongqing 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