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Associations may differ for colon and rectal cancer due to different disease mechanisms and dissemination patterns. Here, we investigated associations between liver fat and cancer recurrence, recurrence-free survival (RFS), and overall survival (OS) among 1596 individuals with stage I-III colon or rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Within a prospective cohort study, we used data from adults recently diagnosed with colon (n\u2009=\u20091080) or rectal (n\u2009=\u2009516) cancer. Liver fat was evaluated using routine contrast-enhanced computed tomography (CT)-scans taken at diagnosis. Cox proportional hazards regression analyses adjusted for clinical and lifestyle-related variables were used to obtain hazard ratios (HRs) and 95% confidence intervals (95% CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 6.4 and 8.8\u2009years, 247 (15%) recurrences (12% for colon and 22% for rectal cancer) and 418 (26%) deaths (25% for colon and 29% for rectal cancer) occurred, respectively. More liver fat was associated with an increased recurrence risk (HRT3vsT1 = 1.60, 95% CI = 1.02 to 2.50), worse RFS (HRT3vsT1 = 1.45, 95% CI = 1.05 to 2.00), and OS (HRT3vsT1 = 1.67, 95% CI = 1.20 to 2.33) among individuals with colon cancer. Liver fat was not associated with recurrence (HRT3vsT1 = 0.70, 95% CI = 0.42 to 1.18), RFS (HRT3vsT1 = 0.87, 95% CI = 0.59 to 1.30), or OS (HRT3vsT1 = 1.15, 95% CI = 0.74 to 1.80) among individuals with rectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>More liver fat was associated with poor clinical outcomes in patients with stage I-III colon cancer. Further studies are needed to confirm these findings and explore mechanistic routes linking liver fat to colon cancer prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djaf324","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:04:13Z","timestamp":1762520653000},"page":"466-475","source":"Crossref","is-referenced-by-count":3,"title":["Liver fat and clinical outcomes in individuals with stage I-III colon or rectal cancer"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-0162-3264","authenticated-orcid":false,"given":"Deborah","family":"Ophoff","sequence":"first","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University & Research , Wageningen,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Bos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam,","place":["The Netherlands"]},{"name":"Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center , Rotterdam,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tjarda","family":"van Heek","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University & Research , Wageningen,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6150-6301","authenticated-orcid":false,"given":"Ben J","family":"Witteman","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University & Research , Wageningen,","place":["The Netherlands"]},{"name":"Department of Gastroenterology and Hepatology, Hospital Gelderse Vallei , Ede,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes H W","family":"de Wilt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Radboud University Medical Center , Nijmegen,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1729-3255","authenticated-orcid":false,"given":"Karteek","family":"Popuri","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Memorial University of Newfoundland , St. John\u2019s, NL,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirza Faisal","family":"Beg","sequence":"additional","affiliation":[{"name":"School of Engineering, Simon Fraser University , Burnaby, BC,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0376-8811","authenticated-orcid":false,"given":"Renate M","family":"Winkels","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University & Research , Wageningen,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8367-2352","authenticated-orcid":false,"given":"Fr\u00e4nzel J B","family":"van Duijnhoven","sequence":"additional","affiliation":[{"name":"Division of Human Nutrition and Health, Wageningen University & Research , Wageningen,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6123-0219","authenticated-orcid":false,"given":"Edward L","family":"Giovannucci","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Harvard T.H. 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