Histopathological growth patterns and positive margins after resection of colorectal liver metastases

Pieter M H Nierop, Diederik J Höppener, Eric P van der Stok, Boris Galjart, Florian E Buisman, Vinod P Balachandran, William R Jarnagin, T Peter Kingham, Peter J Allen, Jinru Shia, Peter B Vermeulen, Bas Groot Koerkamp, Dirk J Grünhagen, Cornelis Verhoef, Michael I D'Angelica*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

23 Citations (Scopus)

Abstract

BACKGROUND: Histopathological growth patterns (HGPs) of colorectal liver metastases (CRLM) may be an expression of biological tumour behaviour impacting the risk of positive resection margins. The current study aimed to investigate whether the non-desmoplastic growth pattern (non-dHGP) is associated with a higher risk of positive resection margins after resection of CRLM.

METHODS: All patients treated surgically for CRLM between January 2000 and March 2015 at the Erasmus MC Cancer Institute and between January 2000 and December 2012 at the Memorial Sloan Kettering Cancer Center were considered for inclusion.

RESULTS: Of all patients (n = 1302) included for analysis, 13% (n = 170) had positive resection margins. Factors independently associated with positive resection margins were the non-dHGP (odds ratio (OR): 1.79, 95% confidence interval (CI): 1.11-2.87, p = 0.016) and a greater number of CRLM (OR: 1.15, 95% CI: 1.08-1.23 p < 0.001). Both positive resection margins (HR: 1.41, 95% CI: 1.13-1.76, p = 0.002) and non-dHGP (HR: 1.57, 95% CI: 1.26-1.95, p < 0.001) were independently associated with worse overall survival.

CONCLUSION: Patients with non-dHGP are at higher risk of positive resection margins. Despite this association, both positive resection margins and non-dHGP are independent prognostic indicators of worse overall survival.

Original languageEnglish
Pages (from-to)911-919
Number of pages9
JournalHPB
Volume22
Issue number6
Early online date14 Nov 2019
DOIs
Publication statusPublished - 1 Jun 2020

Bibliographical note

Copyright © 2019 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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  • EMC OR-01

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