When Maria Carolina Santos Mendes reviewed the CT scans of gastric cancer patients at UNICAMP in Campinas, Brazil, she wasn’t just looking at tumors—she was reading the story written in fat and muscle. What emerged from nearly a decade of data is a powerful new biomarker called VMD, which could transform how doctors predict the course of gastric cancer, the world’s fifth most common cancer. By analyzing routine CT scans from 461 patients treated between 2013 and 2022, researchers at the State University of Campinas uncovered that the radiodensity of visceral fat and muscle—how these tissues absorb X-rays—holds critical clues about survival. This isn’t just about the cancer; it’s about the patient’s entire physiology.
Gastric cancer prognosis has long relied on tumor staging, which maps the size and spread of the disease. But the UNICAMP team, led by researchers from the Faculty of Medical Sciences and the Gleb Wataghin Institute of Physics, believed something was missing. "Today, cancer treatment is still very tumor-centric," says Jun Takahashi, a full professor at IFGW-UNICAMP and co-adviser of the study. "Our proposal is to look at the patient as a whole." That shift in perspective led them to explore body composition—not just as background, but as a dynamic player in disease outcomes.
The VMD marker combines radiodensity values of visceral fat and muscle into a single prognostic tool. Higher fat radiodensity, often signaling inflammation, correlates with worse survival. In muscle, lower radiodensity—indicative of metabolic disruption or atrophy—does the same. But together, they form a clearer picture. Patients with high VMD scores had a median overall survival of just 13.8 months, while those with lower scores lived a median of 58.5 months—nearly five years longer. The findings, published in Clinical Nutrition ESPEN, suggest VMD could help identify high-risk patients earlier, allowing for more tailored, aggressive, or supportive therapies.
What makes this breakthrough especially promising is that it uses existing CT scans—no additional tests, no extra cost. "It’s all in the images we already take," Mendes explains. This means the tool could be rapidly adopted in clinical settings worldwide, particularly in regions where advanced diagnostics are scarce. The study is part of a growing movement toward holistic oncology, where treatment decisions are informed not just by the tumor, but by the body’s response to it.
As cancer care evolves, markers like VMD may become standard in prognosis, helping doctors see beyond the lesion to the person. For patients in Campinas and beyond, this could mean not just longer lives, but more precisely guided ones.