Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

Chen, Haiyan; Dai, Siqi; Fang, Yunxia; Chen, Liubo; Jiang, Kai; Wei, Qichun; Ding, Kefeng

doi:10.3389/fonc.2021.631943

Cited by 11 publications

(19 citation statements)

References 53 publications

(72 reference statements)

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“…Of the 16 studies selected for full-text analysis, seven studies were excluded with reasons. A total of nine studies fulfilled the eligibility criteria and were included in this review ( 12 – 15 , 18 – 22 ).…”

Section: Resultsmentioning

confidence: 99%

“…Irrespective of the etiology, in many patients, the disease gradually progresses to steatohepatitis and cirrhosis resulting in attenuated liver metabolic function and inflammation. Such deranged liver histology provides a fertile ground for seeding and colonization of CRC metastatic cells ( 12 ). To date, many studies have examined the effect of hepatic steatosis on outcomes of CRLM, however, with conflicting results.…”

Section: Introductionmentioning

confidence: 99%

“…To date, many studies have examined the effect of hepatic steatosis on outcomes of CRLM, however, with conflicting results. While some studies report no change in outcomes with hepatic steatosis ( 13 , 14 ), others report poor patient survival and increased risk of recurrence ( 12 , 15 ). Given the ambiguity in literature and the absence of a systematic review, the present study was designed to pool evidence on the effect of hepatic steatosis, irrespective of the etiology, on long-term outcomes of CRLM patients undergoing surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

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The impact of hepatic steatosis on outcomes of colorectal cancer patients with liver metastases: A systematic review and meta-analysis

Yang¹,

Peng²,

Zhou³

2022

Front. Med.

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BackgroundIt is unclear how hepatic steatosis impacts patient prognosis in the case of colorectal cancer with liver metastases (CRLM). The purpose of this review was to assess the effect of hepatic steatosis on patient survival and disease-free survival (DFS) in the case of CRLM.MethodsWe examined the databases of PubMed, CENTRAL, Embase, Google Scholar, and ScienceDirect for studies reporting outcomes of CRLM patients with and without hepatic steatosis. We performed a random-effects meta-analysis using multivariable adjusted hazard ratios (HR).ResultsNine studies reporting data of a total of 14,197 patients were included. All patients had undergone surgical intervention. Pooled analysis of seven studies indicated that hepatic steatosis had no statistically significant impact on patient survival in CRLM (HR: 0.92 95% CI: 0.82, 1.04, I2 = 82%, p = 0.18). Specifically, we noted that there was a statistically significant improvement in cancer-specific survival amongst patients with hepatic steatosis (two studies; HR: 0.85 95% CI: 0.76, 0.95, I2 = 41%, p = 0.005) while there was no difference in overall survival (five studies; HR: 0.97 95% CI: 0.83, 1.13, I2 = 78%, p = 0.68). On meta-analysis of four studies, we noted that the presence of hepatic steatosis resulted in statistically significant reduced DFS in patients with CRLM (HR: 1.32 95% CI: 1.08, 1.62, I2 = 67%, p = 0.007).ConclusionThe presence of hepatic steatosis may not influence patient survival in CRLM. However, scarce data is suggestive of poor DFS in CRLM patients with hepatic steatosis. Further prospective studies taking into account different confounding variables are needed to better assess the effect of hepatic steatosis on outcomes of CRLM.Systematic review registration[https://www.crd.york.ac.uk/prospero/#searchadvanced], identifier [CRD42022320665].

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The impact of hepatic steatosis on outcomes of colorectal cancer patients with liver metastases: A systematic review and meta-analysis

Yang¹,

Peng²,

Zhou³

2022

Front. Med.

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“…Accordingly, liver microenvironments are undeniable components for metastasis. Several clinical studies have reported that pathological conditions such as hepatic steatosis, inflammation and fibrosis accelerate colon-liver metastasis ( Kondo et al, 2016 ; Chen et al, 2021 ). These pathologic alterations in hepatic tissues make the liver microenvironment favorable for liver metastasis, as evidenced by animal studies ( Matsusue et al, 2009 ; Li et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

CGX, a standardized herbal syrup, inhibits colon-liver metastasis by regulating the hepatic microenvironments in a splenic injection mouse model

2022

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Background: Colon-liver metastasis is observed in approximately 50% of patients with colorectal cancer and is a critical risk factor for a low survival rate. Several clinical studies have reported that colon-liver metastasis is accelerated by pathological hepatic microenvironments such as hepatic steatosis or fibrosis. Chunggan syrup (CGX), a standardized 13-herbal mixture, has been prescribed to patients with chronic liver diseases, including fatty liver, inflammation and fibrotic change, based on preclinical and clinical evidence.Aim of the study: In the present study, we investigated anti-liver metastatic the effects of CGX in a murine colon carcinoma (MC38)-splenic injection mouse model.Materials and methods: C57BL/6N mice were administered with CGX (100, 200 or 400 mg/kg) for 14 days before or after MC38-splenic injection under normal and high-fat diet (HFD) fed conditions. Also, above experiment was repeated without MC38-splenic injection to explore underlying mechanism.Results: The number of tumor nodules and liver weight with tumors were sup-pressed by preadministration of CGX in both normal and HFD fed mice. Regarding its mechanisms, we found that CGX administration significantly activated epithelial-cadherin (E-cadherin), but decreased vascular endothelial-cadherin (VE-cadherin) in hepatic tissues under MC38-free conditions. In addition, CGX administration significantly reduced hepatic steatosis, via modulation of lipolytic and lipogenic molecules, including activated adenosine monophosphate activated protein kinase (AMPK) and peroxisome proliferator activated receptor-alpha (PPARα).Conclusion: The present data indicate that CGX exerts an anti-colon-liver metastatic property via modulation of hepatic lipid related microenvironments.

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“…4 Another application of DECT material decomposition concerns fat quantification, which has mainly been applied to detect hepatic steatosis as in the highly prevalent nonalcoholic fatty liver disease. 5 Nonalcoholic fatty liver disease can progress to nonalcoholic steatohepatitis (NASH), which negatively influences survival in a variety of entities, for example, cancer, 6,7 or after surgery. 8 It is also a risk factor for hepatocellular carcinoma 9 and the third most common cause of liver transplant.…”

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confidence: 99%

Fat Quantification in Dual-Layer Detector Spectral Computed Tomography

et al. 2022

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Objectives Fat quantification by dual-energy computed tomography (DECT) provides contrast-independent objective results, for example, on hepatic steatosis or muscle quality as parameters of prognostic relevance. To date, fat quantification has only been developed and used for source-based DECT techniques as fast kVp-switching CT or dual-source CT, which require a prospective selection of the dual-energy imaging mode. It was the purpose of this study to develop a material decomposition algorithm for fat quantification in phantoms and validate it in vivo for patient liver and skeletal muscle using a dual-layer detector-based spectral CT (dlsCT), which automatically generates spectral information with every scan. Materials and Methods For this feasibility study, phantoms were created with 0%, 5%, 10%, 25%, and 40% fat and 0, 4.9, and 7.0 mg/mL iodine, respectively. Phantom scans were performed with the IQon spectral CT (Philips, the Netherlands) at 120 kV and 140 kV and 3 T magnetic resonance (MR) (Philips, the Netherlands) chemical-shift relaxometry (MRR) and MR spectroscopy (MRS). Based on maps of the photoelectric effect and Compton scattering, 3-material decomposition was done for fat, iodine, and phantom material in the image space. After written consent, 10 patients (mean age, 55 ± 18 years; 6 men) in need of a CT staging were prospectively included. All patients received contrast-enhanced abdominal dlsCT scans at 120 kV and MR imaging scans for MRR. As reference tissue for the liver and the skeletal muscle, retrospectively available non–contrast-enhanced spectral CT data sets were used. Agreement between dlsCT and MR was evaluated for the phantoms, 3 hepatic and 2 muscular regions of interest per patient by intraclass correlation coefficients (ICCs) and Bland-Altman analyses. Results The ICC was excellent in the phantoms for both 120 kV and 140 kV (dlsCT vs MRR 0.98 [95% confidence interval (CI), 0.94–0.99]; dlsCT vs MRS 0.96 [95% CI, 0.87–0.99]) and in the skeletal muscle (0.96 [95% CI, 0.89–0.98]). For log-transformed liver fat values, the ICC was moderate (0.75 [95% CI, 0.48–0.88]). Bland-Altman analysis yielded a mean difference of −0.7% (95% CI, −4.5 to 3.1) for the liver and of 0.5% (95% CI, −4.3 to 5.3) for the skeletal muscle. Interobserver and intraobserver agreement were excellent (>0.9). Conclusions Fat quantification was developed for dlsCT and agreement with MR techniques demonstrated for patient liver and muscle. Hepatic steatosis and myosteatosis can be detected in dlsCT scans from clinical routine, which retrospectively provide spectral information independent of the imaging mode.

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Hepatic Steatosis Predicts Higher Incidence of Recurrence in Colorectal Cancer Liver Metastasis Patients

Cited by 11 publications

References 53 publications

The impact of hepatic steatosis on outcomes of colorectal cancer patients with liver metastases: A systematic review and meta-analysis

The impact of hepatic steatosis on outcomes of colorectal cancer patients with liver metastases: A systematic review and meta-analysis

CGX, a standardized herbal syrup, inhibits colon-liver metastasis by regulating the hepatic microenvironments in a splenic injection mouse model

Fat Quantification in Dual-Layer Detector Spectral Computed Tomography

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