Primary Tumor Lymphovascular Invasion Negatively Affects Survival After Colorectal Liver Metastasis Resection?

Abstract

Background: About 50% of the patients with colorectal adenocarcinoma will present with liver metastasis and 20% are synchronic. Liver resection is associated with improvement in survival in comparison to chemotherapy alone. Aim: To analyze the overall survival in patients submitted to liver resection of colorectal cancer metastasis and prognostic factors related to the primary and secondary tumors. Methods: A retrospective analysis of a prospectively maintained database regarding demographic, primary tumor and liver metastasis characteristics. Results: There were 84 liver resections due to colorectal cancer metastasis in the period. The 5-year disease-free and overall survivals were 27.5% and 48.8% respectively. The statistically significant factors for survival were tumor grade (p=0.050), lymphovascular invasion (p=0.021), synchronous metastasis (p=0.020), as well as number (p=0.004), bilobar distribution (p=0.019) and diameter of the liver metastasis over 50 mm (p=0.027). Remained as independent negative predictive factors: lymphovascular invasion (HR=2.7; CI 95% 1.106-6.768; p=0.029), synchronous metastasis (HR=2.8; CI 95% 1.069-7.365; p=0.036) and four or more liver metastasis (HR=1.7; CI 95% 1.046-2.967; p=0.033). Conclusion: The resection of liver metastasis of colorectal adenocarcinoma leads to good survival rates. Lymphovascular invasion was the single prognostic factor related to the primary tumor. Synchronous disease and four or more metastasis were the most significant factors related to the secondary tumor.

Identification of a 5-gene-based signature to predict prognosis and correlate immunomodulators for rectal cancer

“…It is therefore important to identify vascular invasion-related biomarkers to better diagnose and classify rectal cancer patients. However, until now, no validated tumour markers have been identi ed [41][42][43]. Our ndings suggested that the vascular invasion is critical for the progression of colorectal cancer which warrants further investigation.…”

“…Some authors have reported that vascular invasion was a strong prognosticator for rectal cancer that in uenced disease progression and survival [37][38][39]. Thus, a few analyses have failed to indicate the prognostic value of vascular invasion in colorectal, colon, and rectal cancer survival [40,41]. It is therefore important to identify vascular invasion-related biomarkers to better diagnose and classify rectal cancer patients.…”

Re-Hepatectomy Means More Morbidity? A Multicentric Analysis

“…Prognosis of patients with colorectal cancer is strongly linked to liver metastasis treatment 5 . Liver is the most common recurrence site, and the multidisciplinary evaluation is important to select benefited patients and the best treatment option 14 .…”