Supplementary file 1_Preoperative CT-derived liver fat fraction and visceral adipose tissue index enhance postoperative recurrence risk stratification in colorectal cancer.docx

N1–2 stage (hazard ratio [HR], 3.332; 95% confidence interval [CI], 1.807-6.145), elevated carbohydrate antigen 19-9 (CA19-9; HR, 2.414; 95% CI, 1.459-3.994), lymphovascular invasion (HR, 2.166; 95% CI, 1.250-3.752), VATI per 1-standard-deviation increase (HR, 1.519; 95% CI, 1.217-1.896), and LFF per 1-standard-deviation increase (HR, 2.228; 95% CI, 1.728-2.871) were independently associated with recurrence-free survival.

C-indices were 0.851, 0.809, and 0.828 in the training, external, and prospective cohorts, respectively. Prospective 12- and 24-month AUCs were 0.759 (95% CI, 0.242-1.000) and 0.890 (95% CI, 0.709-1.000), with the latter based on only 20 evaluable patients. The combined validation cohort yielded a C-index of 0.813 and 12- and 24-month AUCs of 0.807 and 0.860.</p>Conclusion<p>CT-derived VATI and LFF improved risk stratification beyond routine clinicopathologic variables.

The prospective findings remain exploratory and require confirmation in larger cohorts before clinical implementation.</p>