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Ibrahim MK, Simon TG, Rinella ME. Extrahepatic Outcomes of Nonalcoholic Fatty Liver Disease: Nonhepatocellular Cancers. Clin Liver Dis 2023; 27:251-273. [PMID: 37024206 DOI: 10.1016/j.cld.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) encompasses the entire spectrum of fatty liver disease in individuals without significant alcohol consumption, including isolated steatosis, steatohepatitis, and cirrhosis. The overall global prevalence of NAFLD is estimated to be 30%, and the associated clinical and economic burden will continue to increase. NAFLD is a multisystemic disease with established links to cardiovascular disease, type 2 diabetes, metabolic syndrome, chronic kidney disease, polycystic ovarian syndrome, and intra- and extrahepatic malignancies. In this article the authors review the potential mechanisms and current evidence for the association between NAFLD and extrahepatic cancers and the resultant impact on clinical outcomes.
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Affiliation(s)
- Maryam K Ibrahim
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Tracey G Simon
- Harvard Medical School, Boston, MA, USA; Division of Gastroenterology and Hepatology, Massachusetts General Hospital, Boston, MA, USA; Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA, USA
| | - Mary E Rinella
- University of Chicago Pritzker School of Medicine; University of Chicago Hospitals.
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2
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Mitsala A, Tsalikidis C, Romanidis K, Pitiakoudis M. Non-Alcoholic Fatty Liver Disease and Extrahepatic Cancers: A Wolf in Sheep’s Clothing? Curr Oncol 2022; 29:4478-4510. [PMID: 35877216 PMCID: PMC9325209 DOI: 10.3390/curroncol29070356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is now considered the main driver and leading cause of chronic liver disease globally. The umbrella term NAFLD describes a range of liver conditions closely related to insulin resistance, metabolic syndrome, diabetes mellitus, obesity, and dyslipidemia. At the same time, several malignancies, including hepatocellular carcinoma and colorectal cancer, are considered to be common causes of death among patients with NAFLD. At first, our review herein aims to investigate the role of NAFLD in developing colorectal neoplasms and adenomatous polyps based on the current literature. We will also explore the connection and the missing links between NAFLD and extrahepatic cancers. Interestingly, any relationship between NAFLD and extrahepatic malignancies could be attributable to several shared metabolic risk factors. Overall, obesity, insulin resistance, metabolic syndrome, and related disorders may increase the risk of developing cancer. Therefore, early diagnosis of NAFLD is essential for preventing the progression of the disease and avoiding its severe complications. In addition, cancer screening and early detection in these patients may improve survival and reduce any delays in treatment.
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Talwar H, McVicker B, Tobi M. p38γ Activation and BGP (Biliary Glycoprotein) Induction in Primates at Risk for Inflammatory Bowel Disease and Colorectal Cancer-A Comparative Study with Humans. Vaccines (Basel) 2020; 8:E720. [PMID: 33276422 PMCID: PMC7712431 DOI: 10.3390/vaccines8040720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/17/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022] Open
Abstract
Colorectal cancer (CRC) is a common cause of cancer-related deaths largely due to CRC liver metastasis (CRLM). Identification of targetable mechanisms continues and includes investigations into the role of inflammatory pathways. Of interest, MAPK is aberrantly expressed in CRC patients, yet the activation status is not defined. The present study assessed p38γ activation in CRC patients, cancer cells, and tissues of cotton top tamarin (CTT) and common marmoset (CM). The primate world is an overlooked resource as colitis-CRC-prone CTT are usually inure to liver metastasis while CM develop colitis but not CRC. The results demonstrate that p38γ protein and phosphorylation levels are significantly increased in CRC patients compared to normal subjects and CTT. Furthermore, p38γ phosphorylation is significantly elevated in human CRC cells and hepatoblastoma cells but not in CM colon. Additionally, carcinoembryonic antigen (CEA) and biliary glycoprotein (BGP) are induced in the CRC patients that showed p38γ phosphorylation. Inhibition of p38 MAPK in CRC cells showed a significant decline in cell growth with no effect on apoptosis or BGP level. Overall, p38γ is activated in CRC tumorigenesis and likely involves CEA antigens during CRLM in humans but not in the CTT or CM, that rarely develop CRLM.
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Affiliation(s)
- Harvinder Talwar
- Research and Development VA Medical Center and Internal Medicine, Wayne State University, Detroit, MI 48201, USA;
| | - Benita McVicker
- Research Service, VA Nebraska-Western Iowa Health Care System, The University of Nebraska Medical Center, Omaha, NE 68105, USA;
| | - Martin Tobi
- Research and Development Service, Department of Internal Medicine, Detroit VAMC, Detroit, MI 48201, USA
- Central Michigan University College of Medicine, Mount Pleasant, MI 48859, USA
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Lee JM, Park YM, Yun JS, Ahn YB, Lee KM, Kim DB, Lee JM, Han K, Ko SH. The association between nonalcoholic fatty liver disease and esophageal, stomach, or colorectal cancer: National population-based cohort study. PLoS One 2020; 15:e0226351. [PMID: 31978054 PMCID: PMC6980645 DOI: 10.1371/journal.pone.0226351] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/25/2019] [Indexed: 12/12/2022] Open
Abstract
We investigated the association between nonalcoholic fatty liver disease (NAFLD) and gastrointestinal tract cancer in the general population. Retrospective data on individuals aged ≥20 years who received healthcare checkups from January 1, 2009 to December 31, 2009 were analyzed using the National Health Insurance Database in Korea. NAFLD was defined based on the fatty liver index (FLI ≥60). The primary outcome was newly diagnosed esophageal, stomach, or colorectal cancer using ICD-10 codes during follow-up until 31 December 2017. Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). Among 8,120,674 subjects, 936,159 adults (11.5%) were identified as having NAFLD. Their mean age was 46.7 ± 14.1 years, and 52.1% were male. During the follow-up period (7.2 years), 3,792 esophageal, 57,292 stomach and 68,769 colorectal cancer cases were identified. FLI ≥60 was significantly associated with the development of esophageal (HR 2.10, 95% CI 1.88-2.35), stomach (HR 1.18, 95% CI 1.14-1.22), and colon cancer (HR, 1.23, 95% CI 1.19-1.26) after multivariable adjustment. Compared to subjects without NAFLD, all-cause mortality in patients with esophageal (HR 1.46, 95% CI 1.28-1.67), stomach (HR 1.26, 95% CI 1.18-1.34), and colorectal cancer (HR 1.16, 95% CI 1.10-1.22) was significantly increased in subjects with NAFLD (FLI ≥60). NAFLD defined using FLI was a good predictive indicator for GI tract malignancy and all-cause mortality in the general population. Subjects with NAFLD are needed for active surveillance of esophageal, stomach, and colorectal cancers.
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Affiliation(s)
- Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Moon Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, United States of America
| | - Jae-Seung Yun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yu-Bae Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang-Moon Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dae Bum Kim
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ji Min Lee
- Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail: (S-HK); (KH)
| | - Seung-Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail: (S-HK); (KH)
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Chen J, Bian D, Zang S, Yang Z, Tian G, Luo Y, Yang J, Xu B, Shi J. The association between nonalcoholic fatty liver disease and risk of colorectal adenoma and cancer incident and recurrence: a meta-analysis of observational studies. Expert Rev Gastroenterol Hepatol 2019; 13:385-395. [PMID: 30791768 DOI: 10.1080/17474124.2019.1580143] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIM Lifestyle modification plays a key role in nonalcoholic fatty liver disease (NAFLD) and colorectal adenoma and/or cancer (CRA/CRC) development. However, the association between NAFLD and the risk of CRA/CRC has not been carefully evaluated. METHODS In this meta-analysis, we assessed 21 eligible studies including 124,206 participants to determine the association between NAFLD and the risk of incident and recurrent CRA/CRC. RESULTS NAFLD presence was associated with an increased risk of any incident CRA (aOR: 1.30, 95% CI: 1.19-1.43) and advanced incident CRA/CRC (aOR: 1.57, 95% CI: 1.21-2.04). The severity of NAFLD affected this correlation: compared to mild and/or moderate NAFLD, severe NAFLD was associated with an increased risk of incident CRA/CRC (aOR: 2.19, 95% CI: 1.33-3.60). Although pooled cOR revealed that NAFLD was associated with an increased risk of recurrent CRA/CRC (cOR = 1.73; 95% CI: 1.12-2.68), after adjustment for confounding factors, NAFLD had less correlation with the risk of recurrent CRA/CRC (aOR: 1.81, 95% CI: 0.70-4.65). CONCLUSIONS The presence and severity of NAFLD are associated with an increased risk of incident CRA/CRC. However, there is insufficient evidence to indicate that NAFLD is associated with an increased risk of recurrent CRA/CRC.
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Affiliation(s)
- Jin Chen
- a Department of Postgraduates , Zhejiang Chinese Medical University , Hangzhou , Zhejiang , China
| | - Dongxue Bian
- b Department of Digestive Disease , Yancheng TCM Hospital Affiliated to Nanjing University of Chinese Medicine , Yancheng , Jiangsu , China
| | - Shufei Zang
- c Department of Endocrinology , The Fifth Affiliated Hospital of Fudan University , Shanghai , China
| | - Zongxing Yang
- d Department of Infectious Disease , Hangzhou Xixi hospital , Hangzhou , Zhejiang , China
| | - Guoyan Tian
- e Department of Transformation Medical platform , Hangzhou Normal University Affiliated Hospital , Hangzhou , Zhejiang , China
| | - Yan Luo
- e Department of Transformation Medical platform , Hangzhou Normal University Affiliated Hospital , Hangzhou , Zhejiang , China
| | - Jing Yang
- e Department of Transformation Medical platform , Hangzhou Normal University Affiliated Hospital , Hangzhou , Zhejiang , China
| | - Beibei Xu
- f Department of Postgraduates , China Medical University , Shenyang , Liaoning , China
| | - Junping Shi
- g Department of Liver Diseases , Hangzhou Normal University Affiliated Hospital , Hangzhou , Zhejiang , China
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6
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Wu K, Zhai MZ, Weltzien EK, Cespedes Feliciano EM, Meyerhardt JA, Giovannucci E, Caan BJ. Non-alcoholic fatty liver disease and colorectal cancer survival. Cancer Causes Control 2018; 30:165-168. [PMID: 30443695 DOI: 10.1007/s10552-018-1095-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 11/08/2018] [Indexed: 01/20/2023]
Abstract
PURPOSE Liver diseases including non-alcoholic fatty liver disease (NAFLD) and ensuing alterations to the micro-environment may affect development of liver metastasis. Mirroring the rise in obesity rates, prevalence of NAFLD is increasing globally. Our objective was to examine the association between NAFLD and mortality in colorectal cancer patients. METHODS Colorectal Cancer-Sarcopenia and Near-term Survival (C-SCANS) is a retrospective cohort study which included 3,262 stage I-III patients, aged 18-80 years, and diagnosed between 2006 and 2011 at Kaiser Permanente Northern California. Cox proportional hazards regression was used to calculate multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CI). RESULTS After up to 10 years of follow-up, 879 deaths, including 451 from CRC were identified. Cases diagnosed with NAFLD before and within 1 month after CRC diagnosis (pre-existing NAFLD; n = 83) had a HR of 1.64 (95% CI 1.06-2.54) for overall and a HR of 1.85 (95% CI 1.03-3.30) for CRC-specific mortality compared to those without NAFLD. Findings did not differ significantly by sex, stage, tumor location, and smoking status, and were also similar when restricted to obese patients only. CONCLUSIONS Independent of body mass index and prognostic indicators, CRC patients with pre-existing NAFLD had a worse prognosis than those without NAFLD.
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Affiliation(s)
- Kana Wu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | | | - Erin K Weltzien
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Edward Giovannucci
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bette J Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
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Chen ZF, Dong XL, Huang QK, Hong WD, Wu WZ, Wu JS, Pan S. The combined effect of non-alcoholic fatty liver disease and metabolic syndrome on colorectal carcinoma mortality: a retrospective in Chinese females. World J Surg Oncol 2018; 16:163. [PMID: 30097069 PMCID: PMC6086998 DOI: 10.1186/s12957-018-1461-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 08/01/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND This research aimed to investigate whether metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) had both individual and synergistic effects on the prognosis for female colorectal carcinoma (CRC) patients. METHODS The relationship between CRC prognosis and NAFLD as well as MetS was evaluated in 764 female participants. Based on the NAFLD level, patients were divided into significant NAFLD (SNAFLD), "moderate" and "severe" level, and non-SNAFLD, "non" and "mild" level. All the patients were categorized into four subgroups according to the status of SNAFLD and MetS and then a comparison of CRC prognosis among those four groups was performed. RESULTS NAFLD, SNAFLD, and MetS were independent factors for CRC-specific mortality with the adjustment of age and other confounders. The hazard ratio (HR) of CRC-specific mortality in MetS (+) SNAFLD (+) group was significantly higher than that in other three groups. Relative excess risk of interaction (RERI) was 2.203 with 95% CI ranged from 0.197 to 4.210, attributable proportion (AP) was 0.444 with range from 0.222 to 0.667, and synergy index (SI) of 2.256 with 95% CI from 1.252 to 4.065, indicating SNAFLD and MetS had a significant synergic effect on CRC-specific mortality. CONCLUSIONS SNAFLD and MetS are independent risk factors for CRC-specific mortality in females. Moreover, those two diseases have a synergistic effect on promoting CRC-specific mortality.
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Affiliation(s)
- Zhou-Feng Chen
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Xiu-Li Dong
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Qing-Ke Huang
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wang-Dong Hong
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Wen-Zhi Wu
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Jian-Sheng Wu
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China
| | - Shuang Pan
- Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, People's Republic of China.
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Phipps AI, Passarelli MN, Chan AT, Harrison TA, Jeon J, Hutter CM, Berndt SI, Brenner H, Caan BJ, Campbell PT, Chang-Claude J, Chanock SJ, Cheadle JP, Curtis KR, Duggan D, Fisher D, Fuchs CS, Gala M, Giovannucci EL, Hayes RB, Hoffmeister M, Hsu L, Jacobs EJ, Jansen L, Kaplan R, Kap EJ, Maughan TS, Potter JD, Schoen RE, Seminara D, Slattery ML, West H, White E, Peters U, Newcomb PA. Common genetic variation and survival after colorectal cancer diagnosis: a genome-wide analysis. Carcinogenesis 2015; 37:87-95. [PMID: 26586795 DOI: 10.1093/carcin/bgv161] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Accepted: 11/13/2015] [Indexed: 12/14/2022] Open
Abstract
Genome-wide association studies have identified several germline single nucleotide polymorphisms (SNPs) significantly associated with colorectal cancer (CRC) incidence. Common germline genetic variation may also be related to CRC survival. We used a discovery-based approach to identify SNPs related to survival outcomes after CRC diagnosis. Genome-wide genotyping arrays were conducted for 3494 individuals with invasive CRC enrolled in six prospective cohort studies (median study-specific follow-up = 4.2-8.1 years). In pooled analyses, we used Cox regression to assess SNP-specific associations with CRC-specific and overall survival, with additional analyses stratified by stage at diagnosis. Top findings were followed-up in independent studies. A P value threshold of P < 5×10(-8) in analyses combining discovery and follow-up studies was required for genome-wide significance. Among individuals with distant-metastatic CRC, several SNPs at 6p12.1, nearest the ELOVL5 gene, were statistically significantly associated with poorer survival, with the strongest associations noted for rs209489 [hazard ratio (HR) = 1.8, P = 7.6×10(-10) and HR = 1.8, P = 3.7×10(-9) for CRC-specific and overall survival, respectively). No SNPs were statistically significantly associated with survival among all cases combined or in cases without distant-metastases. SNPs in 6p12.1/ELOVL5 were associated with survival outcomes in individuals with distant-metastatic CRC, and merit further follow-up for functional significance. Findings from this genome-wide association study highlight the potential importance of genetic variation in CRC prognosis and provide clues to genomic regions of potential interest.
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Affiliation(s)
- Amanda I Phipps
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Michael N Passarelli
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Andrew T Chan
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Tabitha A Harrison
- Public Health Sciences Division , Fred Hutchinson Cancer Research Center , Seattle , WA 98109 , USA
| | - Jihyoun Jeon
- Public Health Sciences Division , Fred Hutchinson Cancer Research Center , Seattle , WA 98109 , USA
| | - Carolyn M Hutter
- Public Health Sciences Division , Fred Hutchinson Cancer Research Center , Seattle , WA 98109 , USA
| | - Sonja I Berndt
- Division of Cancer Epidemiology and Genetics , National Cancer Institute , National Institutes of Health , Bethesda , MD 20892 , USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany.,German Cancer Consortium (DKTK), Heidelberg 69120, Germany
| | - Bette J Caan
- Division of Research , Kaiser Permanente Medical Care Program of Northern California , Oakland , CA 94612 , USA
| | - Peter T Campbell
- Epidemiology Research Program , American Cancer Society , Atlanta , GA 30303 , USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology , Unit of Genetic Epidemiology , German Cancer Research Center (DKFZ) , Heidelberg 69120 , Germany
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics , National Cancer Institute , National Institutes of Health , Bethesda , MD 20892 , USA
| | - Jeremy P Cheadle
- Institute of Cancer and Genetics , School of Medicine , Cardiff University , Cardiff CF14 4XN , UK
| | - Keith R Curtis
- Public Health Sciences Division , Fred Hutchinson Cancer Research Center , Seattle , WA 98109 , USA
| | - David Duggan
- Translational Genomics Research Institute , Phoenix , AZ 85004 , USA
| | - David Fisher
- MRC Clinical Trials Unit , University College London , Aviation House , London WC2B 6NH , UK
| | - Charles S Fuchs
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA 02215, USA
| | - Manish Gala
- Harvard School of Public Health , Boston , MA 02115 , USA
| | - Edward L Giovannucci
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, MA 02115, USA.,Harvard School of Public Health, Boston, MA 02115, USA
| | - Richard B Hayes
- Division of Epidemiology , Department of Population Health , New York University School of Medicine , New York , NY 10016 , USA
| | | | - Li Hsu
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.,Biostatistics Department, University of Washington, Seattle, WA 98195, USA
| | - Eric J Jacobs
- Division of Cancer Epidemiology , Unit of Genetic Epidemiology , German Cancer Research Center (DKFZ) , Heidelberg 69120 , Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research , German Cancer Research Center (DKFZ) , Heidelberg 69120 , Germany
| | - Richard Kaplan
- MRC Clinical Trials Unit , University College London , Aviation House , London WC2B 6NH , UK
| | - Elisabeth J Kap
- Division of Cancer Epidemiology , Unit of Genetic Epidemiology , German Cancer Research Center (DKFZ) , Heidelberg 69120 , Germany
| | - Timothy S Maughan
- Gray Institute for Radiation Oncology and Biology , University of Oxford , Oxford OX3 7DQ , UK
| | - John D Potter
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.,Centre for Public Health Research, Massey University, Wellington 6140, New Zealand
| | - Robert E Schoen
- Department of Medicine and Epidemiology , University of Pittsburgh Medical Center , Pittsburgh , PA 15213 , USA
| | - Daniela Seminara
- Division of Cancer Control and Population Sciences , National Cancer Institute , National Institutes of Health , Bethesda , MD 20892 , USA , and
| | - Martha L Slattery
- Department of Internal Medicine , University of Utah Health Sciences Center , Salt Lake City , UT 84132 , USA
| | - Hannah West
- Institute of Cancer and Genetics , School of Medicine , Cardiff University , Cardiff CF14 4XN , UK
| | - Emily White
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Ulrike Peters
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Polly A Newcomb
- Epidemiology Department, University of Washington, Seattle, WA 98195, USA.,Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
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9
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You J, Huang S, Huang GQ, Zhu GQ, Ma RM, Liu WY, Shi KQ, Guo GL, Chen YP, Braddock M, Zheng MH. Nonalcoholic fatty liver disease: a negative risk factor for colorectal cancer prognosis. Medicine (Baltimore) 2015; 94:e479. [PMID: 25654388 PMCID: PMC4602729 DOI: 10.1097/md.0000000000000479] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is known to be associated with an increased risk of colorectal cancer (CRC). However, the relationship between NAFLD and the prognosis of CRC remains unclear. The primary objective of this study was to evaluate the overall survival (OS) and disease-free survival (DFS) rates in patients with CRC and the secondary objective was to compare clinicopathologic variables which were stratified by NAFLD. We performed a large cohort study of 1314 patients who were first diagnosed with CRC between January 2006 and April 2011. Postoperative follow-up data were collected from out-patient medical records, telephone consultations, and social security death indices. The Kaplan-Meier method was used to calculate the cumulative survival rate. Clinicopathologic variables were analyzed by univariate analysis and multivariate analysis through a Cox proportional hazard regression model. The mean follow-up time was 52.7 ± 25.3 months. Upon baseline comparison, the NAFLD group had significantly higher values of body mass index, triglycerides, and uric acid and significantly lower values of high-density lipoprotein, compared with the non-NAFLD group (P < 0.05 for all). There were no significant differences between the 2 groups with regard to tumor location, TNM staging, tumor differentiation, carcinoembryonic antigen, and vascular invasion. The cumulative 1-, 3-, and 5-year OS rates were 96.1%, 85.2%, and 80.6%, respectively, in the NAFLD group, which were statistically significantly higher than the OS rates of 91.6%, 76.2%, and 67.8%, respectively, in the non-NAFLD group (P = 0.075, P = 0.002, P = 0.030, respectively). There was no difference in DFS rates between the CRC patients with and without NAFLD (P = 0.267). Multivariate analysis showed that the presence of NAFLD was an independent negative risk factor for OS after adjusting for clinicopathologic covariates (hazard ratio = 0.593; 95% confidence interval 0.442, 0.921; P = 0.020), but not for DFS (P = 0.270). NAFLD may play a protective role in OS for CRC patients. Further studies are needed to elucidate the molecular mechanisms of putative protective effects in CRC patients with NAFLD.
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Affiliation(s)
- Jie You
- From the Department of Oncological Surgery (JY, R-MM,G-LG); Department of Infection and Liver Diseases, Liver Research Center, the First Affiliated Hospital of Wenzhou Medical University (SH, G-QH, G-QZ, W-YL, K-QS, Y-PC, M-HZ); School of the First Clinical Medical Sciences, Wenzhou Medical University (SH, G-QZ); Renji School of Wenzhou Medical University (G-QH); Department of Endocrinology, the First Affiliated Hospital of Wenzhou Medical University (W-YL); Institute of Hepatology, Wenzhou Medical University, Wenzhou, China (K-QS, Y-PC, M-HZ); Global Medicines Development, AstraZeneca R&D, Loughborough, United Kingdom (MB)
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10
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Kim EH, Lee H, Chung H, Park JC, Shin SK, Lee SK, Hyung WJ, Lee YC, Noh SH. Impact of metabolic syndrome on oncologic outcome after radical gastrectomy for gastric cancer. Clin Res Hepatol Gastroenterol 2014; 38:372-8. [PMID: 24485596 DOI: 10.1016/j.clinre.2013.11.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 11/21/2013] [Accepted: 11/27/2013] [Indexed: 02/04/2023]
Abstract
BACKGROUND Few studies have reported the relationship between MS and the prognosis of gastric cancer. METHODS Data were collected from 505 patients who underwent radical gastrectomy for gastric cancer between January 2006 and December 2007. After exclusion, remaining 204 patients were divided into two groups based on the presence of MS. RESULTS No significant differences were observed in tumor stage and grade between the MS (n=60) and non-MS (n=144) groups. The median follow-up periods were 53.2±23.5 and 54.7±22.1 months in for the MS and non-MS groups, respectively (P=0.677). Seventeen (28.3%) and 21 (14.6%) patients showed tumor recurrence in the MS and non-MS groups, respectively (P=0.022). In addition, disease-free survival of patients in the MS group was less than in non-MS group (P=0.036). The Cox regression hazard model demonstrated that advanced tumor stage (stage III or IV, HR=17.8, 95% CI=5.3 to 59.4) and presence of MS (HR=2.8, 95% CI=1.3 to 5.8) were independent risk factors for recurrence. CONCLUSION MS may be an important prognostic factor for gastric cancer. Control of MS could improve the therapeutic efficacy of gastric cancer.
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Affiliation(s)
- Eun Hye Kim
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Hyuk Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea.
| | - Hyunsoo Chung
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Jun Chul Park
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Sung Kwan Shin
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Sang Kil Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Woo Jin Hyung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yong Chan Lee
- Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, 250, Seongsanno, Seodaemun-gu, 120-752 Seoul, Republic of Korea
| | - Sung Hoon Noh
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
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