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Fatty liver disease as a predictor of local recurrence following resection of colorectal liver metastases.
MedLine Citation:
PMID:  23354994     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Obesity and tissue adiposity constitute a risk factor for several cancers. Whether tissue adiposity increases the risk of cancer recurrence after curative resection is not clear. The present study analysed the influence of hepatic steatosis on recurrence following resection of colorectal liver metastases. METHODS: A prospective cohort of patients who had primary resection of colorectal liver metastases in two major hepatobiliary units between 1987 and 2010 was studied. Hepatic steatosis was assessed in non-cancerous resected liver tissue. Patients were divided into two groups based on the presence of hepatic steatosis. The association between hepatic steatosis and local recurrence was analysed, adjusting for relevant patient, pathological and surgical factors using Cox regression and propensity score case-match analysis. RESULTS: A total of 2715 patients were included. The cumulative local (liver) disease-free survival rate was significantly better in the group without steatosis (hazard ratio (HR) 1·32, 95 per cent confidence interval 1·16 to 1·51; P < 0·001). On multivariable analysis, hepatic steatosis was an independent risk factor for local liver recurrence (HR 1·28, 1·11 to 1·47; P = 0·005). After one-to-one matching of cases (steatotic, 902) with controls (non-steatotic, 902), local (liver) disease-free survival remained significantly better in the group without steatosis (HR 1·27, 1·09 to 1·48; P = 0·002). Patients with steatosis had a greater risk of developing postoperative liver failure (P = 0·001). CONCLUSION: Hepatic steatosis was an independent predictor of local hepatic recurrence following resection with curative intent of colorectal liver metastases. Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors:
Z Z R Hamady; M Rees; F K Welsh; G J Toogood; K R Prasad; T K John; J P A Lodge
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-28
Journal Detail:
Title:  The British journal of surgery     Volume:  -     ISSN:  1365-2168     ISO Abbreviation:  Br J Surg     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Affiliation:
Department of Hepatobiliary Surgery, Hampshire Hospitals, Basingstoke, Leeds University, Leeds, UK; Hepatopancreatobiliary and Transplant Unit, St James's University Hospital, Leeds University, Leeds, UK. zaed.hamady@doctors.org.uk.
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