The Importance of Body Fat Composition Evaluated by Computed Tomography and Its Prognostic Significance in Patients with Testicular Cancer

Abstract

Introduction: To investigate the relationship between visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area (SMA) ratios and testicular cancer stage. Methods: Between 2018 and 2023, 94 patients with testicular cancer were evaluated for demographic data, pathological results, and cancer stages. VAT, SAT, and SMA were measured in cm2 using computed tomography (CT) scans. The ratios of SMA/SAT, SMA/VAT, and SAT/VAT were calculated to assess their relationships with cancer stage. Results: A statistically significant moderate positive correlation was found between tumor stage and the VAT/SAT ratio (r=0.35, p=0.001). The mean VAT/SAT ratio was 0.64±0.43 for stage 1 tumors, 0.81±0.41 for stage 2 tumors, and 1.32±0.29 for stage 3 tumors, indicating statistically significant differences (p=0.001). Comparisons of the groups revealed that the VAT/SAT ratio was significantly higher in stage 3 tumors than in stage 1 and 2 tumors (p=0.001 and p=0.018, respectively). No significant differences were observed between stages 1 and 2. Similarly, only the VAT/SAT ratio differed significantly between localized disease and systemic disease (0.65±0.43 and 0.86±0.44, respectively, p=0.023). Conclusion: Given that body composition parameters provide a more refined assessment of obesity than body mass index and are readily available from routine CT scans, they can serve as valuable tools for tumor staging and prognostication in patients with testicular cancer.

Keywords

• chemotherapy
• computed tomography
• skeletal muscle area
• subcutaneous adipose tissue
• testicular cancer
• visceral adipose tissue