title: Obesity rather than neoadjuvant chemotherapy predicts steatohepatitis in patients with colorectal metastasis.
abstract: BACKGROUND
  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.
authors: Division of Surgical Oncology, Department of Surgery and James Graham Brown Cancer, University of Louisville School of Medicine, Louisville, KY 40202, USA.
authors: Matthew
authors: M
authors: Bower
authors: Chris
authors: C
authors: Wunderlich
authors: Russell
authors: R
authors: Brown
authors: Charles R
authors: CR
authors: Scoggins
authors: Kelly M
authors: KM
authors: McMasters
authors: Robert C G
authors: RC
authors: Martin
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D015992:Body Mass Index; D015179:Colorectal Neoplasms / Q000473:pathology*; D005234:Fatty Liver / Q000209:etiology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D009765:Obesity / Q000150:complications*
chemical_list: D000970:Antineoplastic Agents