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25.09.2019 | Original Article | Ausgabe 2/2020

Gastric Cancer 2/2020

Risk factors for nonalcoholic fatty liver disease after gastrectomy for gastric cancer

Zeitschrift:
Gastric Cancer > Ausgabe 2/2020
Autoren:
Keita Kouzu, Hironori Tsujimoto, Makoto Nishikawa, Manabu Harada, Takao Sugihara, Hiromi Nagata, Shuichi Hiraki, Yoshihisa Yaguchi, Risa Takahata, Shinsuke Nomura, Nozomi Ito, Yusuke Ishibashi, Yujiro Itazaki, Satoshi Tsuchiya, Kazuo Hase, Yoji Kishi, Hideki Ueno
Wichtige Hinweise

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The online version of this article (https://​doi.​org/​10.​1007/​s10120-019-01009-8) contains supplementary material, which is available to authorized users.

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Abstract

Background

Nonalcoholic fatty liver disease (NAFLD) refers to hepatic steatosis caused by something other than alcoholic liver injury, and often occurs after gastrointestinal surgeries such as pancreatoduodenectomy and gastrectomy. This study aimed to identify the risk factors for NAFLD after gastrectomy for gastric cancer.

Methods

A total of 721 patients who underwent gastrectomy for gastric cancer and plane abdominal computed tomography (CT) preoperatively and 1 year after surgery were included in this study. NAFLD was defined as having a mean hepatic CT attenuation value of < 40 Hounsfield units. We retrospectively examined the relationship between the onset of NAFLD and clinicopathological findings to identify the risk factors associated with the development of NAFLD after gastrectomy.

Results

The incidence of postoperative NAFLD was 4.85% (35/721). The univariate analysis identified the following factors as being significantly associated with the incidence of NAFLD: age, preoperative BMI ≥ 25 kg/m2, tumor depth of pT3 ≤, lymph node metastasis grade of pN2 ≤, cholecystectomy, D2 lymphadenectomy, adjuvant chemotherapy, high preoperative cholinesterase serum level, and low grade of preoperative FIB-4 index. Adjuvant chemotherapy (p < 0.001) and high preoperative cholinesterase serum level (p = 0.021) were identified as independent risk factors for NAFLD 1 year after gastrectomy.

Conclusion

Our study showed that adjuvant chemotherapy with S-1 and high level of serum cholinesterase were considered as the risk factors for NAFLD occurring after gastrectomy for gastric cancer.

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