Fatty liver disease as a predictor of local recurrence following resection of colorectal liver metastases. Issue 6 (28th January 2013)

• Record Type: Journal Article
• Authors: Hamady, Z. Z. R.; Rees, M.; Welsh, F. K.; Toogood, G. J.; Prasad, K. R.; John, T. K.; Lodge, J. P. A.
• Is Part Of: British journal of surgery. Volume 100:Issue 6(2013:Jun.)
• Page Start: 820
• Page End: 826
• Publication Date: 2013-01-28
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.9057
• Languages: English
• ISSNs: 0007-1323

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Background</title> <p> <bold>Obesity and tissue adiposity constitute a risk factor for several cancers. Whether tissue adiposity increases the risk of cancer recurrence after curative resection is not clear. The present study analysed the influence of hepatic steatosis on recurrence following resection of colorectal liver metastases.</bold> </p> </sec> <sec id="abs1-2" sec-type="section"> <title>Methods</title> <p> <bold>A prospective cohort of patients who had primary resection of colorectal liver metastases in two major hepatobiliary units between 1987 and 2010 was studied. Hepatic steatosis was assessed in non‐cancerous resected liver tissue. Patients were divided into two groups based on the presence of hepatic steatosis. The association between hepatic steatosis and local recurrence was analysed, adjusting for relevant patient, pathological and surgical factors using Cox regression and propensity score case‐match analysis.</bold> </p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results</title> <p> <bold>A total of 2715 patients were included. The cumulative local (liver) disease‐free survival rate was significantly better in the group without steatosis (hazard ratio (HR) 1·32, 95 per cent confidence interval 1·16 to 1·51; <italic>P</italic> < 0·001). On multivariable analysis, hepatic steatosis was an independent risk factor for local liver recurrence (HR 1·28, 1·11 to 1·47; <italic>P</italic> = 0·005). After one‐to‐one matching of cases (steatotic, 902) with controls (non‐steatotic, 902), local (liver) disease‐free survival remained significantly better in the group without steatosis (HR 1·27, 1·09 to 1·48; <italic>P</italic> = 0·002). Patients with steatosis had a greater risk of developing postoperative liver failure (<italic>P</italic> = 0·001).</bold> </p> </sec> <sec id="abs1-4" sec-type="section"> <title>Conclusion</title> <p> <bold>Hepatic steatosis was an independent predictor of local hepatic recurrence following resection with curative intent of colorectal liver metastases.</bold> </p> </sec> </abstract>