Tumor growth pattern as predictor of colorectal liver metastasis recurrence

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• 作者：Rafael S. Pinheiro ; M.D.^a ; ^{rsnpinheiro@gmail.com" class="auth_mail} ; Paulo Herman ; M.D.^a ; Renato M. Lupinacci ; M.D.^a ; Quirino Lai ; M.D.^b ; Evandro S. Mello ; M.D.^c ; Fabricio F. Coelho ; M.D.^a ; Marcos V. Perini ; M.D.^a ; Vincenzo Pugliese ; M.D.^a ; Wellington Andraus ; M.D.^a ; Ivan Cecconello ; M.D.^a ; Luiz Carneiro D'Albuquerque ; M.D.^a
• 关键词：Colorectal neoplasms ; Colorectal metastasis ; Hepatectomy ; Pathology ; surgical ; Recurrence
• 刊名：The American Journal of Surgery
• 出版年：April, 2014
• 年：2014
• 卷：207
• 期：4
• 页码：493-498
• 全文大小：520 K

文摘

Background

Surgical resection is the gold standard therapy for the treatment of colorectal liver metastases (CRM). The aim of this study was to investigate the impact of tumor growth patterns on disease recurrence.

Methods

We enrolled 91 patients who underwent CRM resection. Pathological specimens were prospectively evaluated, with particular attention given to tumor growth patterns (infiltrative vs pushing).

Results

Tumor recurrence was observed in 65 patients (71.4%). According to multivariate analysis, 3 or more lesions (P = .05) and the infiltrative tumor margin type (P = .05) were unique independent risk factors for recurrence. Patients with infiltrative margins had a 5-year disease-free survival rate significantly inferior to patients with pushing margins (20.2% vs 40.5%, P = .05).

Conclusions

CRM patients with pushing margins presented superior disease-free survival rates compared with patients with infiltrative margins. Thus, the adoption of the margin pattern can represent a tool for improved selection of patients for adjuvant treatment.