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Am J Surg. 2013 Jun;205(6):685-90. doi: 10.1016/j.amjsurg.2012.07.034. Epub 2013 Feb 4.

Obesity rather than neoadjuvant chemotherapy predicts steatohepatitis in patients with colorectal metastasis.

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1
Division of Surgical Oncology, Department of Surgery and James Graham Brown Cancer, University of Louisville School of Medicine, Louisville, KY 40202, USA.

Abstract

INTRODUCTION:

Neoadjuvant chemotherapy has been associated with an increased risk of surgery because of chemotherapy-associated steatohepatitis and sinusoidal obstruction. The aim of the current study was to assess for other predictors of steatohepatitis and sinusoidal obstruction and to determine the role of obesity as a risk factor in patients with colorectal liver metastasis (CLM).

METHODS:

An institutional review board-approved prospectively maintained database of 1,605 patients who underwent hepatic procedures for CLM from 2001 to 2009 was reviewed.

RESULTS:

In a review of 208 resected patients, body mass index was the only predictor of liver injury according to multivariate analysis (P < .001, odds ratio = 3.88). Diabetes, neoadjuvant chemotherapy, sleep apnea, alcohol use, tobacco use, age, and sex were not significant predictors. Among preoperative chemotherapy patients, BMI was a predictor of chemotherapy liver injury according to multivariate analysis (P < .0001). The rate of obesity (BMI >30) was 36%, and among obese patients (BMI >30) the rate of steatosis or steatohepatitis was 39%.

CONCLUSIONS:

Obesity is the strongest predictor of steatosis and steatohepatitis in patients with CLM, and this risk is independent of the use of preoperative chemotherapy.

PMID:
23388422
DOI:
10.1016/j.amjsurg.2012.07.034
[Indexed for MEDLINE]
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