Impact of metabolic dysfunction-associated steatotic liver disease on liver metastases and survival in colorectal cancer: a retrospective cohort study.

[OBJECTIVE] This study investigates the impact of the presence and severity of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) on prognosis and metastasis in patients with colorectal cancer (CRC).

[METHODS] This retrospective observational study included 242 CRC patients who underwent PET-CT imaging at a tertiary university hospital in Turkey between 2014 and 2019. Hepatosteatosis presence and severity were assessed non-contrast CT. Demographic data, BMI, comorbidities, smoking history, family history, cancer stage, metastasis status, laboratory results, and FIB-4 scores were recorded. Relationships between hepatosteatosis and survival, metastases, and lab findings were analyzed.

[RESULTS] The mean age was 62.4 ± 11.6 years; 64.5% were female. Hepatosteatosis was present in 125 patients (51.7%), with 90 having mild-to-moderate and 35 having severe hepatosteatosis. BMI was significantly lower in patients without hepatosteatosis ( < 0.002). Rates of liver and extrahepatic metastases at diagnosis were significantly higher in patients with hepatosteatosis compared to those without ( < 0.05). Additionally, stage 4C cancer was more common among patients with hepatosteatosis ( < 0.05).

[CONCLUSIONS] This study, the first to explore CRC metastases in MASLD patients, shows a significant association between MASLD and liver metastases. CRC patients with MASLD had higher rates of advanced-stage disease and liver metastases at diagnosis, correlating with shorter survival and poorer prognosis. These findings underscore the importance of early screening and monitoring in CRC patients with MASLD.