Abstract
BACKGROUND: Morphomics, a computed tomography-based body composition assessment, helps predicting esophageal cancer outcomes, but its link to bioelectrical impedance analysis (BIA) and functional assessments such as hand grip strength (HGS) and cardiopulmonary exercise testing (CPET) remains unclear. AIM: To investigate correlations between morphomics and BIA, HGS, CPET, and assess its ability to predict low cardiorespiratory fitness (CRF). METHODS: Fifty esophageal cancer patients underwent multi-level morphomics, BIA, HGS, and CPET. Correlations were analyzed using heatmaps and scatter plots, and logistic regression assessed morphomic predictive value for low CRF. RESULTS: T11 is the only level with complete morphomic data, making it the most applicable. To ensure reliability, T11 and its adjacent levels, T10-12, were included in the subsequent analysis. Dorsal muscle group volume from T10-12 morphomics all correlated positively with BIA muscle components (r = 0.56-0.68, all P < 0.001), HGS (r = 0.4-0.48, all P < 0.001), and CPET variables (r = 0.43-0.51, all P < 0.001). Subcutaneous fat area and visceral fat area from morphomics correlated with body fat percentage (r = 0.58-0.67, all P < 0.001) and negatively with CPET parameters (r = -0.33 to -0.52, all P < 0.05). Morphomics also showed potential in identifying low CRF, with an area under the receiver operating characteristic curve of 0.778. CONCLUSION: T11 morphomics shows strong correlation with BIA, HGS, and CPET, and may serve as a practical tool for preoperative risk assessment in esophageal cancer patients.