Tumor growth pattern as predictor of colorectal liver metastasis recurrence

Pinheiro, Rafael Soares; Herman, Paulo; Lupinacci, Renato M.; Lai, Quirino; Mello, Evandro S.; Coelho, Fabrício Ferreira; Perini, Marcos Vinícius; Pugliese, Vincenzo; Andraus, Wellington; Cecconello, Ivan; D’Albuquerque, Luiz Augusto Carneiro

doi:10.1016/j.amjsurg.2013.05.015

Cited by 46 publications

(55 citation statements)

References 22 publications

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“…In addition, the specific number of nodules that drives a worse prognosis is actively debated. Whereas most authors consider four or more lesions to be a relative cut‐off associated with a worse prognosis, other investigators have reported more than one, two or even more than seven lesions . The highest level of evidence comes from a meta‐analysis conducted by Smith and McCall, which evaluated 9934 patients who underwent potentially curative therapy (surgical resection and/or ablation).…”

Section: Number Of Liver Metastasesmentioning

confidence: 99%

Pathological factors and prognosis of resected liver metastases of colorectal carcinoma: implications and proposal for a pathological reporting protocol

et al. 2017

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Colorectal cancer is a leading cause of death worldwide. The liver is the most common site of distant metastases, and surgery is the only potentially curative treatment, although the recurrence rate following surgery is high. In order to define prognosis after surgery, many histopathological features have been identified in the primary tumour. In turn, pathologists routinely report specific findings to guide oncologists on the decision to recommend adjuvant therapy. In general, the pathological report of resected colorectal liver metastases is limited to confirmation of the malignancy and details regarding the margin status. Most pathological reports of a liver resection for colorectal liver metastasis lack information on other important features that have been reported to be independent prognostic factors. We herein review the evidence to support a more detailed pathological report of the resected liver specimen, with attention to: the number and size of liver metastases; margin size; the presence of lymphatic, vascular, perineural and biliary invasion; mucinous pattern; tumour growth pattern; the presence of a tumour pseudocapsule; and the pathological response to neoadjuvant chemotherapy. In addition, we propose a new protocol for the evaluation of colorectal liver metastasis resection specimens.

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Section: Number Of Liver Metastasesmentioning

confidence: 99%

Pathological factors and prognosis of resected liver metastases of colorectal carcinoma: implications and proposal for a pathological reporting protocol

et al. 2017

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“…Growth pattern of tumor is an important prognostic marker in colorectal cancer and CRC tumors show two different kinds of growth patterns, expansive growth with smooth invasive front and infiltrative growth with high coarse and irregular border [27]. Irregular growth pattern and different shapes of cells is a typical form of infiltrative pattern of CRC tumor and is usually characterised with worse prognosis [28,29]. Multiple scoring systems have been presented to describe a tumor growth in different carcinomas [30].…”

Section: Introductionmentioning

confidence: 99%

Expression of β-Catenin and E-Cadherin, their Clinical Significance and Association with Complexity Index of Colon Carcinoma

Ahmad¹,

Hahn-Strömberg²

2016

Adv Genet Eng

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Cell-cell adhesion and communication relies greatly on the E-cadherin/catenin system. Deregulation in this system may result in phenotypic change, which may create an opportunity for tumor cells to differentiate, metastasize and invade neighbouring tissue. In this study, we aimed to assess the protein expression of E-cadherin and β-catenin in the patients diagnosed with colon carcinoma correlating the levels with growth pattern of tumors using complexity index analysis as well as clinical and pathological features of the patients.129 colon carcinoma patients were selected to evaluate the protein expression of E-cadherin and β-catenin through immunohistochemical staining. Complexity index of randomly selected patients diagnosed with colon carcinoma was calculated to examine the growth pattern of the tumor.Expression of adhesion proteins was significantly perturbed in colon carcinoma patients as compared with normal mucosa (p<0.05). Similarly the growth pattern of tumor i.e., complexity index value was significantly related to differentiation of the tumor (p=0.002) and Duke's stages (p=0.026).Our results suggest that E-cadherin and β-catenin may play an indicative role in colorectal cancer invasion and disease progression which may act as prognostic markers in colorectal carcinoma. Also complexity index and adhesive proteins distribution are two independent markers which should aid the development of novel strategies for prevention as well as individual treatment of colon carcinoma.

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“…Previous studies identified that the invasive growth type correlates strongly with liver metastasis and is one of the most important factors that determines prognosis for patients with CRC (3,4,18,19). Moreover, the infiltrating type carries a high risk of liver metastasis and a worse prognosis compared to the expanding type (4,20).…”

Section: Discussionmentioning

confidence: 99%

“…The tumor-node-metastasis (TMN) classification is based on the standard staging process, which helps understand the histopathological features of CRC and is an important factor in deciding its prognosis. The invasive growth types have also been evaluated as valuable prognostic factors (2,3). In patients with CRC, the invasive growth type influences local recurrence, liver metastasis and disease-free survival (2–5).…”

Section: Introductionmentioning

confidence: 99%

Myofibroblast distribution is associated with invasive growth types of colorectal cancer

et al. 2016

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Both the invasive growth types of colorectal cancer (CRC) and the number of myofibroblasts have been associated with histopathological factors such as lymph node and liver metastasis, and local recurrence. However, there are few studies, that have assessed the association between invasive growth type and myofibroblast distribution in CRC. We aimed to evaluate the relationship between the clinicopathological factors of CRC and two invasive growth types, the expanding and infiltrating types. We categorized 150 cases of pT3 CRC into the expanding and infiltrating types and measured the myofibroblast density of three histological layers: the submucosa (SM), the muscularis propria (MP) and the subserosa (SS). We compared these two invasive growth types and analyzed the relationship between clinicopathological factors and myofibroblast density. Myofibroblast density was significantly higher in the infiltrating type than that in the expanding type (P<0.05). In the lymph node metastasis-positive group of the infiltrating type, myofibroblast density in MP was significantly higher than that in the lymph node metastasis-negative group (P<0.001). In the infiltrating type, the group with the higher level of lymphatic invasion had a significantly higher density of myofibroblasts in the MP than the group with the lower level of lymphatic invasion (P<0.01). These results suggest that myofibroblasts participate more in the infiltrating type compared with the expanding type of CRC. It would appear that myofibroblasts present in the MP play an important role in the malignant potential of the infiltrating type compared to the expanding type.

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Tumor growth pattern as predictor of colorectal liver metastasis recurrence

Cited by 46 publications

References 22 publications

Pathological factors and prognosis of resected liver metastases of colorectal carcinoma: implications and proposal for a pathological reporting protocol

Pathological factors and prognosis of resected liver metastases of colorectal carcinoma: implications and proposal for a pathological reporting protocol

Expression of β-Catenin and E-Cadherin, their Clinical Significance and Association with Complexity Index of Colon Carcinoma

Myofibroblast distribution is associated with invasive growth types of colorectal cancer

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