Association of radiologically defined hepatosteatosis and colorectal cancer liver metastases.

Abstract

367 Background: Non alcoholic fatty liver disease (NAFLD) is common, with a prevalence estimated at 15-35%. NAFLD was found to be an independent risk factor for colorectal cancer (CRC). The relationship between CRC and metastasis to a fatty liver has not been well established. We performed a retrospective chart review to address the association of radiologic hepatosteatosis and liver metastases in patients with CRC. Methods: Medical records of 291 patients diagnosed with colorectal adenocarcinoma between 2006-2010 at MetroHealth Medical Center were reviewed. Patients with CRC and no abdominal imaging within 3 months of diagnosis were excluded. Demographic and tumor related data were collected. Presence of hepatic steatosis was defined by radiographic reports (CT, MRI, or US). Results: 6/38 (18.8%) patients with hepatosteatosis had liver metastases, compared to 60/253 (23.7%) with no steatosis. The difference did not reach statistical difference (p=0.40). Hepatosteatosis was noted in 27/280 (9.6%) contrasted CTs, 4/42 (9.5%) MRIs and 12/54 (22.2%) U/S. 66 (22.7%) patients had liver metastases. Patients with ≤3 metastases were less frequent in the non-fatty 22/59 (37.3%) vs fatty liver group 3/6 (50%), but this was not statistically significant (p=0.67). Fatty liver patients were more likely to have a stage ≤ II compared to non-fatty liver patients (OR 2.40, p=0.018). Patients with hepatosteatosis had a higher mean BMI (32.8 vs 27.6, p<0.001). BMI was an independent predictor of steatosis. Alcohol consumption was not associated with BMI or steatosis. There was no statistically significant difference between racial groups and gender with respect to steatosis and liver metastases. Conclusions: This retrospective study suggests that liver metastases in CRC patients are less common in those with fatty livers compared to those with non-fatty livers. CRC patients with hepatosteatosis were also more likely to have earlier stage disease. Larger studies are needed to confirm these findings.