16P - Risk factors and prognostic value of non-alcoholic fatty liver disease (NAFLD) in hormone positive, non-metastatic breast cancer receiving adjuvant hormonal therapy

Background

NAFLD is a condition commonly found in breast cancer. This study aims at investigating risk factors, and prognostic impact of NAFLD in hormone-positive breast cancer receiving adjuvant hormonal treatment.

Methods

We retrospectively investigated hormone-positive, HER-2-negative, non-metastatic breast cancer patients, diagnosed since January 2010 - December 2018. All patients received hormonal treatment either tamoxifen (Tam), aromatase inhibitor (AI), or tamoxifen followed by aromatase inhibitor (Tam+AI). Clinical data on metabolic profiles (BMI, waist circumference, cholesterol, triglyceride, LDL, HDL, diabetes, or metabolic syndrome [MS]) were collected. Fatty liver displayed by USG. NAFLD diagnosed during hormonal treatment was analyzed based on metabolic risk factors, type of hormonal treatment, and disease-free survival (DFS).

Results

There were 146 eligible patients. MS was detected in 44.5%, and obesity was in 11 % patients. Tam were used in 44.5% patients, whereas Tam+AI in 21.2%, and AI in 34.2%. NAFLD was diagnosed in 31.5% patients. There were significant association between obesity (OR = 3.20; 95%CI 1.12- 9.31; p = 0.024); waist circumference ≥ 80 cm (OR = 7.30; 95%CI 2.43-21.93; p = 0.000); triglyceride ≥ 150 mg/dL (OR = 2.19; 95% CI 1.05-4.56; p = 0.035); HDL ≤ 40 mg/dl (OR = 2.58; 95% CI 1.06-6.32; p = 0.03); MS (OR = 2.65; 95% CI 1.29-5.43; p = 0.007) with arising of NAFLD. Multivariate analysis showed that waist circumference was the strongest predictor to NAFLD (HR 5.92, 95% CI 1.7-19.8; p = 0.004). NAFLD was detected more frequently in tamoxifen-use patients (36.8%) compare to AI (16.6%) (OR = 1.94; 95% CI = 0.90-4.19; p < 0.08). Interestingly, there were less progression events in patients with NAFLD compared to non-NAFLD (23.9% vs. 40%; OR = 0.47, 95% CI 0.2-1.04; p = 0.058). Median survival time was 64 months in non-NAFLD; whereas in NAFLD group the median survival was not reached (HR = 1.813, 95% CI 0.93-3.55; p = 0.08).

Conclusions

Waist circumference predicts NAFLD in breast cancer during adjuvant hormonal therapy. NAFLD patients tend to have longer DFS.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.