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©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Feb 15, 2024; 16(2): 331-342
Published online Feb 15, 2024. doi: 10.4251/wjgo.v16.i2.331
Tumour response following preoperative chemotherapy is affected by body mass index in patients with colorectal liver metastases
Hua-Chuan Song, Hang-Cheng Zhou, Ping Gu, Bing Bao, Quan Sun, Tian-Ming Mei, Wei Cui, Kang Yao, Huan-Zhang Yao, Shen-Yu Zhang, Yong-Shuai Wang, Rui-Peng Song, Ji-Zhou Wang
Hua-Chuan Song, Huan-Zhang Yao, Ji-Zhou Wang, Department of General Surgery, Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, Anhui Province, China
Hua-Chuan Song, Shen-Yu Zhang, Yong-Shuai Wang, Rui-Peng Song, Ji-Zhou Wang, Department of Hepatobiliary Surgery, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Hang-Cheng Zhou, Ping Gu, Department of Pathology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Bing Bao, Department of Gastrointestinal Surgery, Tongcheng People’s Hospital, Tongcheng 231400, Anhui Province, China
Quan Sun, Tian-Ming Mei, Department of Gastrointestinal Surgery, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
Wei Cui, Kang Yao, Department of General Surgery, Xuancheng People’s Hospital, Xuancheng 242000, Anhui Province, China
Co-first authors: Hua-Chuan Song and Hang-Cheng Zhou.
Author contributions: Song HC and Zhou HC contributed equally to this work; Song HC, Zhou HC, Song RP, and Wang JZ designed the research study; Song HC, Bao B, Sun Q, Mei TM, Yao K, Cui W, and Yao HZ performed the research and collected the data; Zhou HC and Gu P assessed the pathological section; Song HC, Zhang SY, and Wang YS analysed and interpreted data; Song HC and Zhou HC wrote the manuscript; Song RP and Wang JZ revised and proofed the manuscript; and all authors have read and approve the final manuscript.
Supported by National Natural Science Foundation of China, No. 82170618.
Institutional review board statement: The study was reviewed and approved by the First Affiliated Hospital of University of Science and Technology of China Institutional Review Board (Approval No. 2023KY-323).
Clinical trial registration statement: This study is registered at Medical Research Registration and Filing Information System of China (
www.medicalresearch.org.cn), Filing number is MR 34 23 043810.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Ji-Zhou Wang, PhD, Chief, Professor, Department of General Surgery, Provincial Hospital Affiliated to Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei 230001, Anhui Province, China. wangjoe@ustc.edu.cn
Received: October 17, 2023
Peer-review started: October 17, 2023
First decision: November 16, 2023
Revised: December 5, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: February 15, 2024
ARTICLE HIGHLIGHTS
Research background
Radical surgery is the most efficacious therapeutic approach for curing colorectal liver metastases (CRLMs). Preoperative chemotherapy is widely recommended for patients with CRLM. However, a considerable number of patients exhibit poor response to preoperative chemotherapy.
Research motivation
Epidemiological evidence suggests that body mass index (BMI) is associated with colorectal carcinogenesis and outcomes. Exploring the relationship between BMI and pathological response to preoperative chemotherapy may help us better manage CRLM patients.
Research objectives
This study was designed to explore the predictive value of BMI regarding the pathologic response following preoperative chemotherapy for CRLMs.
Research methods
A retrospective analysis was conducted on the clinical and pathological data of 126 CRLM patients who underwent hepatectomy after preoperative chemotherapy. We analysed the potential predictive factors affecting tumour regression grade (TRG). TRG 1-2 was defined as a complete pathological response.
Research results
The rate of complete tumour response was significantly higher in patients with low BMI. Multivariate analysis revealed that low BMI independently predicted complete tumour response to preoperative chemotherapy. The low BMI group exhibited a longer median progression-free survival (PFS) than the high BMI group.
Research conclusions
In CRLM patients receiving preoperative chemotherapy, a low BMI may be associated with better tumour response and longer PFS.
Research perspectives
Whether deliberately increasing physical activity and weight loss may improve the response to chemotherapy in obese CRLM patients is an interesting topic worthy of further exploration.
