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. 2021 Mar 9:11:631943.
doi: 10.3389/fonc.2021.631943. eCollection 2021.

Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

Haiyan Chen  1   2 , Siqi Dai  2   3 , Yimin Fang  2   3 , Liubo Chen  2   3 , Kai Jiang  2   3 , Qichun Wei  1   2 , Kefeng Ding  2   3
Affiliations

Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

Haiyan Chen et al. Front Oncol. .

Erratum in

Abstract

Purpose: Colorectal liver metastasis (CRLM) is the major cause of death due to colorectal cancer. Although great efforts have been made in treatment of CRLM, about 60-70% of patients will develop hepatic recurrence. Hepatic steatosis was reported to provide fertile soil for metastasis. However, whether hepatic steatosis predicts higher incidence of CRLM recurrence is not clear. Therefore, we aimed to determine the role of hepatic steatosis in CRLM recurrence in the present study. Methods: Consecutive CRLM patients undergoing curative treatment were retrospectively enrolled and CT liver-spleen attenuation ratio was used to detect the presence of hepatic steatosis. In patients with hepatic steatosis, we also detected the presence of fibrosis. Besides, a systematic literature search was performed to do meta-analysis to further analyze the association between hepatic steatosis and CRLM recurrence. Results: A total of 195 eligible patients were included in our center. Patients with hepatic steatosis had a significantly worse overall (P = 0.0049) and hepatic recurrence-free survival (RFS) (P = 0.0012). Univariate and multivariate analysis confirmed its essential role in prediction of RFS. Besides, hepatic fibrosis is associated with worse overall RFS (P = 0.039) and hepatic RFS (P = 0.048). In meta-analysis, we included other four studies, with a total of 1,370 patients in the case group, and 3,735 patients in the control group. The odds ratio was 1.98 (95% CI: 1.25-3.14, P = 0.004), indicating that patients with steatosis had a significantly higher incidence of CRLM recurrence. Conclusion: In summary, patients with hepatic steatosis had a significantly worse overall and hepatic RFS and it's associated with higher incidence of CRLM recurrence.

Keywords: L/S ratio; colorectal cancer; hepatic recurrence; hepatic steatosis; liver metastasis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of patient inclusion.
Figure 2
Figure 2
Hepatic steatosis is a predictor of overall and hepatic RFS of CRLM. Patients with steatosis (N = 39) had a significantly worse overall RFS (A) (P = 0.0049) and hepatic RFS (B) (P = 0.0012) than Patients without steatosis (N = 156).
Figure 3
Figure 3
Hepatic fibrosis is associated with worse overall and hepatic RFS in patients with hepatic steatosis. In patients with hepatic steatosis, patients with fibrosis (N = 24) had a significantly worse overall RFS (A) (P = 0.039) and hepatic RFS (B) (P = 0.048) than Patients without fibrosis (N = 15).
Figure 4
Figure 4
Multivariate Cox regression analysis was used to determine predictive factors for overall RFS (A) and hepatic RFS (B) in CRLM patients.
Figure 5
Figure 5
Forest plot of OR for association of hepatic steatosis and fibrosis and risk of CRLM recurrence by meta-analysis. OR was 1.98 (95% CI: 1.25–3.143, P = 0.004) in the random-effects model by meta-analysis. It indicated that hepatic steatosis and fibrosis is associated with higher risk of CRLM recurrence.
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