Abstract
<strong>Background:</strong> Nonalcoholic fatty liver disease (NAFLD) is associated with poor prognosis after radical breast cancer surgery. Locally advanced breast cancer (LABC) has a higher recurrence rate than early breast cancer does and requires multidisciplinary treatment including cardiotoxic and liver-metabolized anthracycline. The aim of the current study was to investigate the association between NAFLD and the prognosis and morbidity of patients with LABC. <strong>Patients and Methods:</strong> This single-center, retrospective, cohort study included patients with stage III breast cancer who underwent surgery between July 2015 and December 2018. Hepatic steatosis was defined as a ratio of liver-to-spleen attenuation (L/S) of <1.12 on pre-treatment unenhanced computed tomography. The primary outcome was recurrence-free survival (RFS). We used the log-rank test to compare survival curves and the Cox proportional hazards model to adjust for covariates. <strong>Results:</strong> We analyzed 44 patients, including 6 with NAFLD. The median follow-up time was 852.5 days. On univariate and multivariate analyses, NAFLD was not significantly associated with RFS (hazard ratio [HR], 1.474; 95% confidence interval [CI], 0.324–6.706, and HR, 1.297; 95% CI, 0.263–6.399, respectively). Neither cardiovascular events nor secondary cancers were associated with NAFLD. Known prognostic factors of breast cancer—such as older age, high histological grade, and estrogen receptor negativity—were significantly associated with a shorter RFS. <strong>Conclusion:</strong> When treating patients with LABC, physicians and patients should not worry much about the prognostic impact of mild NAFLD. <strong>Highlights:</strong> <ul><li>This single-center, retrospective, cohort study investigated the association between nonalcoholic fatty liver disease (NAFLD) and the prognosis and morbidity of patients with locally advanced breast cancer (LABC).</li><li>We found that mild NAFLD was not significantly associated with RFS and neither cardiovascular disease nor other cancers occurred.</li><li>The results of the current study imply that mild NAFLD based on the criteria given by Iwasaki et al. is not a prognostic factor for LABC.</li></ul>
Highlights
Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity in patients with breast cancer and is associated with poor prognosis
On univariate and multivariate analyses, NAFLD was not significantly associated with recurrence-free survival (RFS)
When treating patients with Locally advanced breast cancer (LABC), physicians and patients should not worry much about the prognostic impact of mild NAFLD. This single-center, retrospective, cohort study investigated the association between nonalcoholic fatty liver disease (NAFLD) and the prognosis and morbidity of patients with locally advanced breast cancer (LABC)
Summary
Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity in patients with breast cancer and is associated with poor prognosis. Patients with breast cancer have a higher rate of NAFLD than the general population does [1, 2]. Two retrospective cohort studies showed that patients with breast cancer with NAFLD were at a higher risk of recurrence. One study was from Korea and showed that recurrence-free survival (RFS) after radical surgery was significantly longer in the control group than in the NAFLD group, and NAFLD was a risk factor for recurrence on multivariate analysis [2]. The study included patients with estrogen receptorpositive, human epidermal growth factor receptor 2-negative early-stage breast cancer who received adjuvant tamoxifen [3]. Nonalcoholic fatty liver disease (NAFLD) is associated with poor prognosis after radical breast cancer surgery.
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