Metabolic dysfunction-associated steatotic liver disease increases the incidence of metachronous liver metastases from TNM stage 0-II colorectal cancer.

BACKGROUND AND AIMS

Metachronous colorectal liver metastases (CRLM) had been the main cause of death in most colorectal cancer (CRC) patients after curative surgery. However, the clinical impact of the pre-existing metabolic dysfunction-associated steatotic liver disease (MASLD) on metachronous CRLM remains unclear, the present study aims to clarify this issue.

METHODS

This study retrospectively enrolled in 2155 CRC patients who underwent curative surgery at the Sixth Affiliated Hospital of Sun Yat-sen University from 2017 to 2018, including 300 cases with MASLD and 1855 cases of Control group. Cox regression and Kaplan-Meier curves were constructed to evaluate the influencing factors and cumulative incidence of recurrence (CIR) of metachronous CRLM.

RESULTS

The pre-existing MASLD was an independent risk factor for metachronous CRLM in TNM stage 0-II CRC patients (HR, 2.696; 95% CI 1.553-4.681; p < 0.001), and this association persisted for both early (HR, 2.309; 95% CI 1.008-5.291; p = 0.048) and late (HR, 2.791; 95% CI 1.321-5.894; p = 0.007) metachronous CRLM. However, pre-existing MASLD was not independently associated with metachronous CRLM in TNM stage III CRC patients. In TNM stage 0-II CRC patients, the 5-year hepatic CIR rate in the MASLD group was significantly higher than that in the Control group (9.3% vs. 4.0%, p < 0.001). MASLD had no significant impact on metachronous extrahepatic metastases for TNM stage 0-II and stage III CRC patients.

CONCLUSIONS

The pre-existing MASLD is an independent and important risk factor predicting hepatic recurrence for CRC patients of TNM stage 0-II after curative surgery.