Association between pre-diagnosis hepatic fat infiltration and risk of liver metastasis and mortality in a large cohort of stage I-III colorectal cancer survivors

The first aims of this study are to radiologically confirm and classify liver metastasis according to size, location and number using CT scans obtained post-diagnosis during follow-up and to confirm and identify previously undetected NAFLD/NASH cases and assess degree of hepatic fat infiltration using CT-scans obtained at the time of diagnosis/ cancer workup. We will then assess whether independent of body fatness and prognostic factors pre-existing NAFLD and NASH is associated with higher risk of liver metastasis and CRC mortality and associations are stronger among NAFLD patients with higher degree of hepatic fat infiltration. We will also assess whether observed associations are modified by co-morbidities related to dysregulated insulin and lipid metabolism (e.g., history of diabetes, cardiovascular disease, visceral obesity, sarcopenia).

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