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Non-Alcoholic Fatty Liver Disease May Be a Risk Factor for Liver Metastasis After Radical Surgery for Colorectal Cancer: A Retrospective Study

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Abstract

Purpose

Distant metastasis develops in approximately one-third of patients with colorectal cancer (CRC) who undergo radical surgery, and colorectal liver metastasis (CRLM) is the most common form of distant metastasis in CRC. Hepatectomy is the only potentially curative treatment for CRLM, but few patients with metastatic CRC meet the criteria for this radical resection, and the 5-year survival rate is poor. Identifying risk factors for CRLM is critical. Non-alcoholic fatty liver disease (NAFLD) is an independent risk factor for CRC. However, the effect of NAFLD on CRC liver metastasis after radical surgery remains unclear. Therefore, we examined the impact of NAFLD-associated hepatic fibrosis on liver metastasis after radical surgery for CRC.

Methods

We retrospectively analyzed data from 388 patients who underwent curative surgery for CRC at our hospital between April 2008 and March 2015. The patients’ clinical results, surgical procedures, postoperative course, and pathological and survival data were collected from the hospital records. The NAFLD fibrosis score was calculated and used to divide the patients into two groups (NAFLD and non-NAFLD).

Results

Recurrence was observed in 83/388 (21.4%) patients after a mean follow-up of 65.6 ± 15.1 months. Twenty-five patients had liver metastasis: 8 in the NAFLD group (8/45; 17.8%) and 17 in the non-NALFD group (17/343; 5.0%) (p = 0.004). Liver metastasis-free survival was significantly worse in the NAFLD than non-NAFLD group (p < 0.001). NAFLD and cancer stage were independent risk factors for liver metastasis recurrence.

Conclusion

NAFLD may be a risk factor for liver metastasis in patients with CRC who undergo curative surgery.

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Data Availability

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Acknowledgements

We thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript. A preprint version is available (https://doi.org/https://doi.org/10.21203/rs.3.rs-2145570/v1).

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Authors and Affiliations

  1. Department of General and Digestive Surgery, Kanazawa Medical University Hospital, 1-1 Daigaku, Uchinada, Kahoku, Ishikawa, 920-0293, Japan

    Takashi Miyata, Yuki Shinden, Shota Motoyama, Yuta Sannomiya, Hozumi Tamezawa, Taigo Nagayama, Hisashi Nishiki, Akifumi Hashimoto, Daisuke Kaida, Hideto Fujita, Nobuhiko Ueda & Hiroyuki Takamura

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  1. Takashi Miyata
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  2. Yuki Shinden
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Contributions

Takashi M and Hiroyuki T designed the study. Takashi M, Yuki S, SM, Yuta S, Hozumi T, TN, HN, AH, DK, HF, and NU collected and analyzed the data. Takashi M wrote the paper. Hiroyuki T revised the paper critically. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takashi Miyata.

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Ethics Approval

The study protocol was approved by the Institutional Review Committee for the Department of General and Digestive Surgery, Kanazawa Medical University Hospital, Ishikawa, Japan (No. I457), and the study was conducted in accordance with the ethical criteria outlined in the World Medical Association Declaration of Helsinki.

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Written informed consent to participate in this study was obtained from all patients.

Consent for Publication

Written informed consent for the publication of this study was obtained from all patients.

Competing Interests

The authors declare no competing interests.

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Miyata, T., Shinden, Y., Motoyama, S. et al. Non-Alcoholic Fatty Liver Disease May Be a Risk Factor for Liver Metastasis After Radical Surgery for Colorectal Cancer: A Retrospective Study. J Gastrointest Canc (2024). https://doi.org/10.1007/s12029-024-01042-6

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