Effect of Non-Alcoholic Liver Disease on Recurrence Rate and Liver Regeneration after Liver Resection for Colorectal Liver Metastases

Background: Resection of metastases is the only potential cure for patients with liver metastasis from colorectal cancer (CRC-LM). But despite an improved overall 5-year survival, the recurrence rate is still as high as 60%. Non-alcoholic fatty liver disease (NAFLD) can decrease the liver’s capacity to regenerate after resection and might also affect cancer recurrence, potentially by elevating transforming growth factor β, levels of specific metalloproteinases, and oxidative stress. The objective of the present work was to determine the effect of the histologic features of nafld on cancer recurrence and liver regeneration. Methods: This retrospective analysis considered 60 patients who underwent an R0 hepatectomy for CRC-LM. Volumetric analysis of the liver was calculated using axial view, portovenous phase, 2.5 mm thickness, multiphasic computed tomography images taken before and after surgery. The histologic features of NAFLD (steatosis, inflammation, and ballooning) were scored using the nafld activity score, and the degree of fibrosis was determined. Results: The hepatic recurrence rate was 38.33%. Median overall survival duration was 56 months. Median disease-free survival duration was 14 months, and median hepatic disease-free survival duration was 56 months. Multivariate analysis revealed significant correlations of hepatic disease-free survival with hepatocyte ballooning (p = 0.0009), lesion diameter (p = 0.014), and synchronous disease (p = 0.006). Univariate and multivariate analyses did not reveal any correlation with degree of steatosis or recurrence rate. Conclusions: This study reveals an important potential negative effect of hepatocyte ballooning on hepatic disease-free survival.