Fatty liver disease inhibits colorectal cancer spread to the liver

This study examined whether fatty liver disease protects colorectal cancer patients from developing liver metastasis.

Colorectal cancer (CRC) is most likely to metastasize (spread) to the liver. Liver metastasis accounts for 50% of all cases of metastatic colorectal cancer. Since very limited treatments are available for liver metastasis, research often focuses on preventing liver metastasis before it occurs.

Hepatic steatosis (HS), also known as fatty liver disease, is a condition in which the liver cannot process fats normally and as result contains high amounts of fat. HS can be assessed by imaging scans comparing the density of the liver and the spleen (a measurement called liver-spleen attenuation ratio). HS also damages the cells of the liver, causing high levels of liver enzymes in the blood (liver enzymes are proteins normally found within liver cells but that may leak inout of damaged cells). This study examined whether the changes to liver cells due to HS might affect recurrence free survival (RFS; the time between surgery and until recurrence of the disease or death occurs) in colorectal cancer patients.

604 patients with CRC were enrolled in this study. Each patient received an imaging scan (a computer tomography, also called a CT scan) in preparation for surgery. 10.4% of these patients were noted to have HS based on their scans. All patients were followed and recurrence of the cancer and its location were noted.

5 years after surgery, RFS was 82.1% for normal weight HS patients, compared to 68.1% of patients without HS. Only 3.9% of normal weight patients with HS experienced liver metastasis, compared to 9.6% of patients without HS. Obese or overweight patients with HS did not show any benefit in outcomes. Normal weight patients with HS and normal liver enzyme levels showed better outcomes than those with HS and elevated liver enzymes. The rate of cancer metastasis to organs other than the liver was similar between all patients, further validating the results of this study. These results suggest that liver-spleen attenuation ratio could be used to predict the likelihood of liver metastases in colorectal cancer patients.

This study concluded that fatty liver disease inhibits colorectal cancer spread to the liver and increases recurrence free survival.

While this article provided new and important insight into liver metastasis from colorectal cancer, the clinical application of these findings are still uncertain.