ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Sex-specific CT-derived muscle and fat phenotypes in colon cancer: implications for nutritional and metabolic assessment
Provisionally accepted
Fernanda Mucarzel1
Patricia Guirado Peláez2Virginia Soria Utrilla3,4,5
Rocio Fernández Jiménez2,5,6
Fiorella Palmas1,7*Francisco José Sánchez Torralvo3,4,5
Rosa Burgos1,7,8
José Manuel García Almeida2,5,6Gabriel Olveira3,4,5- 1Vall d'Hebron University Hospital, Barcelona, Spain
- 2Hospital Universitario Virgen de la Victoria, Málaga, Spain
- 3Hospital Regional Universitario de Malaga, Málaga, Spain
- 4Hospital Quironsalud Malaga, Málaga, Spain
- 5Centro de Investigacion Biomedica en Red de Cancer, Madrid, Spain
- 6Instituto de Investigacion Biomedica de Malaga, Málaga, Spain
- 7Vall d'Hebron Institut de Recerca, Barcelona, Spain
- 8Universitat Autonoma de Barcelona, Barcelona, Spain
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Background: Computed Tomography (CT)-derived analysis of Body Composition (BC) provides detailed phenotyping of skeletal muscle and adipose tissue, offering insight into nutritional and metabolic risk in oncology. Objective: To characterize sex-and age-specific muscle and adipose tissue phenotypes in patients with colon cancer and describe their patterns across postoperative outcomes. Methods: Multicentric observational cross-sectional study including Colorectal Cancer (CRC) patients undergoing laparoscopic elective surgery. Preoperative CT scans at L3 were analyzed for muscle and adipose tissue quantity and radiodensity. Differences in BC parameters between patient groups (according to presence of complications, hospital stay and disease stage by sex) were assessed using Student's t-test (p < 0.05). Results: 502 CRC patients, predominantly males (62.5%) with a mean age of 68.08±10.62 were included. Sex-specific differences in muscle quality and adipose tissue distribution were observed across postoperative outcomes. In women, lower Subcutaneous Adipose Tissue (SAT) values were observed in those with longer hospital stay and complications (p<0.001), whereas in men, reduced Skeletal Lean Muscle Radiodensity (p<0.001) and higher Visceral Adipose Tissue (VAT) (p=0.013) were found in those with adverse outcomes. These differences were independent of BMI and age. Conclusions: CT-based body composition phenotyping identifies distinct metabolic profiles linked to postoperative risk. Incorporating tissue quality and distribution into nutritional assessment may enhance early identification of vulnerable patients and guide personalized perioperative strategies.
Keywords: computed tomography, colorectal cancer, Body Composition, Hounsfield Units, Postoperative Complications
Received: 20 Oct 2025; Accepted: 10 Nov 2025.
Copyright: © 2025 Mucarzel, Guirado Peláez, Soria Utrilla, Fernández Jiménez, Palmas, Sánchez Torralvo, Burgos, García Almeida and Olveira. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fiorella Palmas, fiorellaximena.palmas@vallhebron.cat
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