Determination of Chemotherapy Associated Fatty Liver Disease Among Colorectal Cancer Patients by Non-Invasive Methods

Objectives: Chemotherapy-associated steatohepatitis (CASH) may increase the risk of cardiovascular, metabolic and liver-related complications. This study aimed to evaluate the frequency and severity of CASH and possible related factors during adjuvant chemotherapy for colorectal cancer (CRC) non-invasively.

Methods: Patients scheduled for adjuvant CRC treatment (FOLFOX-4 or FUFA) were assigned to prospective cohort (PC) or early (9-18 months) (ELT) and late (>18 months) long-term (LLT) follow-up and control groups (CG). PC was evaluated at baseline, third and sixth months for changes in anthropometric measurements, hemogram, blood biochemistry, inflammation markers, serum adipokine levels and hepatic steatosis by magnetic resonance spectroscopy (HS-MRS). The results of ELT, LLT and CG were compared.

Results: Of 21 patients included in PC, 66.7% received FOLFOX-4 and 33.3% FUFA. Males constituted 57.1%. Median age was 62.0 (48.0-77.0). Baseline characteristics were similar for both regimens. HS-MRS significantly increased at third and sixth months compared to baseline (p=0.02). ELT, LLT ve CG included 10, 10, and 20 patients, respectively. Age, gender distribution and anthropometric measurements were similar. HS-MRS tended to be higher in ELT (p=0.11).

Conclusion: Steatosis and CASH frequently develop during 5-fluorouracil and oxaliplatin treatment and may persist for months. Hepatic MRS and biomarkers may allow for non-invasive diagnosis.