P3664 - Exploring the Risk of Colorectal Cancer (CRC) Metastasis in Patients With Fatty Liver: A Nationwide Analysis (2016-2020)

Ruchir Damjibhai. Paladiya, MBBS¹, Danzhu Zhao, DO², Vikash Kumar, MD³, Aalam Sohal, MD⁴, Haleh Vaziri, MD^2
1University of Connecticut Health Center, Hartford, CT; ²University of Connecticut Health Center, Farmington, CT; ³Creighton University School of Medicine, Brooklyn, NY; ⁴Creighton University School of Medicine, Seattle, WA

Introduction: Metabolic Dysfunction Associated Liver Disease (MASLD) previously known as Fatty liver (FL) is the predominant contributor to liver disease, with its prevalence increasing worldwide. Colorectal cancer (CRC) ranks the third most common cancer worldwide, bearing significant morbidity and mortality. Recent research has highlighted the impact of the fatty liver microenvironment on the rate of invasion and metastasis of CRC in in-vitro models, suggesting alterations in the tumor microenvironment (TME). The current study explores the odds of CRC metastasis in patients with FL.

Methods: National Inpatient Sample (NIS) 2016–2020 was used to identify adult patients (age >18 years) with CRC using ICD-10 codes. Patients with missing demographics and mortality data were excluded from the study. Patients were stratified into two groups based on prevalence of FL. Data were collected on patient demographics, Elixhauser Comorbidity Index (ECI), and comorbidities. The outcomes studied were rates of liver, gastrointestinal (GI), non-GI, and lymphoid metastasis. A multivariate logistic regression analysis was performed to evaluate the role of FL on these outcomes.

Results: Of the 814,270 patients, 35,595 (4.37%) had FL. The majority of patients in the FL group were aged >65 years (56%), male (51%) and white race (70%). There was a higher prevalence of diabetes, chronic kidney disease, coagulopathy, obesity, gastroesophageal reflux disease and obstructive sleep apnea among patients with FL. (Table 1) Patients with FL had a higher prevalence of GI metastasis (12.84% vs 11.76%, p=0.005), liver metastasis (30.47% vs 23.78%, p< 0.001), and lymphoid metastasis (11.9% vs. 10.63%, p=0.001) than those who did not have FL (Figure 1). After adjusting for confounding factors (patient demographics, ECI and comorbidities), patients with FL had higher odds of having total metastasis (aOR-1.24, 95% CI- 1.18-1.30, p< 0.001), GI metastasis (aOR-1.08, 95% CI-1-1.16, p=0.030), liver metastasis (aOR-1.38, 95% CI- 1.30-1.45, p< 0.001), lymphoid metastasis (aOR-1.12, 95% CI-1.04-1.21, p=0.003) and in-hospital mortality (aOR-1.84, 95% CI-1.68-2.03,p< 0.001) but not non-GI metastasis (aOR-1, 95% CI-0.93-1.07, p< 0.1).

Discussion: Our study highlights that FL may be associated with higher risk of developing CRC metastasis especially metastasis to the liver. With new treatments for MASLD, it will be interesting to see whether these therapies can impact the metastasis rate in CRC. Further research is needed to confirm these findings.



Disclosures:


Ruchir Damjibhai. Paladiya, MBBS¹, Danzhu Zhao, DO², Vikash Kumar, MD³, Aalam Sohal, MD⁴, Haleh Vaziri, MD². P3664 - Exploring the Risk of Colorectal Cancer (CRC) Metastasis in Patients With Fatty Liver: A Nationwide Analysis (2016-2020), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.