{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,22]],"date-time":"2026-03-22T07:57:04Z","timestamp":1774166224130,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T00:00:00Z","timestamp":1663459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background and aim: Sarcopenia and body composition parameters such as visceral and subcutaneous adipose tissue and visceral-to-subcutaneous adipose tissue ratio have been shown to be relevant biomarkers for prognosis in patients with different types of cancer. However, these findings have not been well studied in anal cancer to date. Therefore, the aim of this study was to evaluate the prognostic value of different body composition parameters in patients undergoing radiation therapy for the treatment of anal cancer with curative intent. Material and Methods: After approval by the institutional ethical committee, we retrospectively identified 81 patients in our local registry, who received radical intensity-modulated radiotherapy for the management of anal squamous cell cancer (ASCC). Clinical information, including body mass index (BMI), survival, and toxicities outcome, were retrieved from the local hospital registry. Based on the pre-therapeutic computer tomography (CT), we measured the total psoas muscle area, visceral adipose tissue area (VAT), subcutaneous adipose tissue area (SAT), and visceral-to-subcutaneous adipose tissue area ratio (VSR). In addition to the classical prognostic factors as T-stage, N-stage, gender, and treatment duration, we analyzed the impact of body composition on the prognosis in univariate and multivariate analyses. Results: Sarcopenia was not associated with increased mortality in anal cancer patients, whereas increased BMI (\u226527 kg\/m2) and VSR (\u22650.45) were significantly associated with worsened overall survival and cancer-specific survival in both univariate and multivariate analyses. VSR\u2014not BMI\u2014was statistically higher in males. Sarcopenia and VSR \u2265 0.45 were associated with advanced T-stages. None of the body composition parameters resulted in a significant increase in treatment-related toxicities. Conclusion: BMI and visceral adiposity are independent prognostic factors for the survival of patients with anal cancer. Measurements to treat adiposity at the time of diagnosis may be needed to improve the survival outcomes for the affected patients.<\/jats:p>","DOI":"10.3390\/cancers14184521","type":"journal-article","created":{"date-parts":[[2022,9,18]],"date-time":"2022-09-18T22:12:43Z","timestamp":1663539163000},"page":"4521","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Body Composition as a Predictor of the Survival in Anal Cancer"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0650-3576","authenticated-orcid":false,"given":"Ahmed Allam","family":"Mohamed","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathrin","family":"Risse","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Stock","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Heinzel","sequence":"additional","affiliation":[{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"},{"name":"Department of Nuclear Medicine, RWTH Aachen University Hospital, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7212-6521","authenticated-orcid":false,"given":"Felix M.","family":"Mottaghy","sequence":"additional","affiliation":[{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"},{"name":"Department of Nuclear Medicine, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Bruners","sequence":"additional","affiliation":[{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"},{"name":"Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Eble","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, RWTH Aachen University Hospital, 52074 Aachen, Germany"},{"name":"Center for Integrated Oncology Aachen, Bonn, Cologne and Duesseldorf (CIO ABCD), 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1093\/jnci\/djz219","article-title":"Recent Trends in Squamous Cell Carcinoma of the Anus Incidence and Mortality in the United States, 2001\u20132015","volume":"112","author":"Deshmukh","year":"2020","journal-title":"JNCI J. 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