Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. May 27, 2026; 18(5): 116822
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.116822
Published online May 27, 2026. doi: 10.4240/wjgs.v18.i5.116822
Visceral obesity exacerbates perioperative muscle loss and impairs survival in colorectal cancer
Yun Wang, Jun Bu, Da-Lin Xu, Jia-Qi Hu, Ming-Hao Zhang, Ke-Jin Zhu, Yang Qi, Department of General Surgery, Sichuan University Affiliated Chengdu Second People’s Hospital, Chengdu 610021, Sichuan Province, China
Yun Wang, Da-Lin Xu, Ke-Jin Zhu, School of Clinical Medicine, Chengdu Medical College, Chengdu 610500, Sichuan Province, China
Jun Bu, Department of General Surgery, West China School of Medicine, Sichuan University, Chengdu 610021, Sichuan Province, China
Chen-Yang Zhan, Department of General Surgery, 363 Hospital, Chengdu 610097, Sichuan Province, China
Jia-Qi Hu, Ming-Hao Zhang, Yang Qi, School of Clinical Medicine, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
Author contributions: Wang Y contributed to study conception, drafting and revision; Wang Y and Bu J contributed to data revision; Wang Y, Bu J, Zhan CY, Xu DL, Hu JQ, Zhang MH, Zhu KJ, and Qi Y contributed to data interpretation; Wang Y, Zhan CY, Xu DL, Hu JQ, Zhang MH, Zhu KJ, and Qi Y contributed to data acquisition and data analysis. All authors reviewed and approved the final manuscript.
AI contribution statement: We used DeepSeek during the final revision stage, but it was used only for language polishing, i.e., refining grammar, word choice, and sentence structure to enhance readability. It was not used for translation, data analysis, or any form of scientific content generation.
Institutional review board statement: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Chengdu Second People’s Hospital, Approval No. [KY]PJ2024015.
Informed consent statement: Due to the retrospective, observational nature of this study, which utilized anonymized data extracted from routine clinical records, the requirement for obtaining written informed consent from individual participants was waived by the Ethics Committee of Chengdu Second People’s Hospital. All patient data were de-identified prior to analysis to safeguard privacy.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: Data are not publicly available to protect patient privacy; however, they can be obtained from the corresponding author upon reasonable request.
Corresponding author: Jun Bu, MD, PhD, Chief Physician, Department of General Surgery, Sichuan University Affiliated Chengdu Second People’s Hospital, No. 10 Qingyun South Street, Jinjiang District, Chengdu 610021, Sichuan Province, China. bj_227688@126.com
Received: November 21, 2025
Revised: December 23, 2025
Accepted: February 10, 2026
Published online: May 27, 2026
Processing time: 188 Days and 0.1 Hours
Revised: December 23, 2025
Accepted: February 10, 2026
Published online: May 27, 2026
Processing time: 188 Days and 0.1 Hours
Core Tip
Core Tip: This study identifies high visceral fat area as an independent driver of perioperative skeletal muscle loss and poor survival in colorectal cancer. Using dynamic computed tomography monitoring, we demonstrate that visceral obesity exacerbates muscle wasting through chronic inflammation. Paradoxically, higher preoperative muscle mass increased skeletal muscle loss risk, potentially indicating underlying myosteatosis. These findings redefine the fat-muscle axis in cancer prognosis and highlight the critical need for preoperative body composition assessment to guide metabolic interventions and improve long-term outcomes.