Histopathologic patterns as markers of prognosis in patients undergoing hepatectomy for colorectal cancer liver metastases – Pushing growth as an independent risk factor for decreased survival

<p>Prognostic Factors After Hepatectomy for Gastric Adenocarcinoma Liver Metastases: Desmoplastic Growth Pattern as the Key to Improved Overall Survival</p>

“…TRG and TTNI were assessed as previously described. 23 HER-2 analysis in the metastases was similar to the primary tumors.…”

“…Future challenges include investigation of sensitive imaging markers for preoperative identification of GP, particularly with Magnetic Resonance Imaging, especially with desmoplastic GP where a dense rim surrounding the tumor may be identified. 23,26 Another possible approach may be a detailed analysis of the GC characteristics and molecular classification, 26 which would allow an upfront stratification of the patients and individualized follow-up. However, tumors undergoing spatial and temporal alterations and selective pressure induced by adjuvant therapies may completely switch the phenotypical findings.…”

“…21 The growth pattern (GP) of metastases, reflecting distinct characteristics of the tumor microenvironment, also constitutes a potential prognostic factor. GP has shown to be relevant in CRLM [22][23][24][25] and seems to represent the path to pursue in the selection of patients for Hp. 10,26 In our study, we sought to investigate both clinical and histopathological factors, with emphasis on GCLM's GP, potentially associated with an improved outcome after Hp.…”

Liver Metastases and Histological Growth Patterns: Biological Behavior and Potential Clinical Implications—Another Path to Individualized Medicine?

“…One may raise the question about patients with several metastases; in our study [11], the majority of the CRCLM presented the same GP. It would be a very interesting study to see if in patients submitted to second and third hepatectomy the GP remained the same; some studies have assessed this and it seems that there is maintenance of GP [36].…”

“…They are defined as expansive (when tumor growth compresses the hepatocytes), desmoplastic (with presence of fibrous tissue in the periphery of the tumor), and replacement (when tumor infiltrates the hepatocytes without architectural changes) (Figures 1 and 2). Our group and others have demonstrated that a pushing growth pattern is related to a worse prognosis [10] while a desmoplastic growth pattern is associated with a more favorable outcome [11]. What is particularly interesting about the GP is that the information is readily available on routine H&E pathological examination and does not require lengthy or expensive ancillary studies.…”