Prospective study of association of liver fat with clinical outcomes among individuals with stage I-III colon or rectal cancer

A multicenter prospective cohort study in The Netherlands evaluated the association of liver fat accumulation with clinical outcomes among patients recently diagnosed with stage I to III colon (n=1080) or rectal (n=516) cancer. Liver fat was evaluated using routine contrast-enhanced CT scans taken at diagnosis. 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 increased recurrence risk (tertile 3 versus 1 HR 1.60; 95% CI 1.02-2.50), worse recurrence-free survival (1.45; 1.05-2.00), and worse overall survival (1.67; 1.20-2.33) among the colon cancer patients. Liver fat was not associated with recurrence, RFS, of OS among the rectal cancer patients. The authors conclude that more liver fat was associated with poor clinical outcomes in patients with stage I-III colon cancer.