Liver fat and clinical outcomes in individuals with stage I-III colon or rectal cancer

Liver fat accumulation has been associated with impaired colorectal cancer prognosis. Associations may differ for colon and rectal cancer due to different disease mechanisms and dissemination patterns. Here, we investigated associations between liver fat and cancer recurrence, recurrence-free survival (RFS), and overall survival (OS) among 1596 individuals with stage I-III colon or rectal cancer.

Within a prospective cohort study, we used data from adults recently diagnosed with colon (n = 1080) or rectal (n = 516) cancer. Liver fat was evaluated using routine contrast-enhanced computed tomography (CT)-scans taken at diagnosis. Cox proportional hazards regression analyses adjusted for clinical and lifestyle-related variables were used to obtain hazard ratios (HRs) and 95% confidence intervals (95% CIs).

During a median follow-up of 6.4 and 8.8 years, 247 (15%) recurrences (12% for colon and 22% for rectal cancer) and 418 (26%) deaths (25% for colon and 29% for rectal cancer) occurred, respectively. More liver fat was associated with an increased recurrence risk (HRT3vsT1 = 1.60, 95% CI = 1.02 to 2.50), worse RFS (HRT3vsT1 = 1.45, 95% CI = 1.05 to 2.00), and OS (HRT3vsT1 = 1.67, 95% CI = 1.20 to 2.33) among individuals with colon cancer. Liver fat was not associated with recurrence (HRT3vsT1 = 0.70, 95% CI = 0.42 to 1.18), RFS (HRT3vsT1 = 0.87, 95% CI = 0.59 to 1.30), or OS (HRT3vsT1 = 1.15, 95% CI = 0.74 to 1.80) among individuals with rectal cancer.

More liver fat was associated with poor clinical outcomes in patients with stage I-III colon cancer. Further studies are needed to confirm these findings and explore mechanistic routes linking liver fat to colon cancer prognosis.