Histopathological growth patterns of liver metastasis: updated consensus guidelines for pattern scoring, perspectives and recent mechanistic insights

Emily Latacz, Diederik Höppener, Ali Bohlok, Sophia Leduc, Sébastien Tabariès, Carlos Fernández Moro, Claire Lugassy, Hanna Nyström, Béla Bozóky, Giuseppe Floris, Natalie Geyer, Pnina Brodt, Laura Llado, Laura Van Mileghem, Maxim De Schepper, Ali W. Majeed, Anthoula Lazaris, Piet Dirix, Qianni Zhang, Stéphanie K. PetrilloSophie Vankerckhove, Ines Joye, Yannick Meyer, Alexander Gregorieff, Nuria Ruiz Roig, Fernando Vidal-Vanaclocha, Larsimont Denis, Rui Caetano Oliveira, Peter Metrakos, Dirk J. Grünhagen, Iris D. Nagtegaal, David G. Mollevi, William R. Jarnagin, Michael I. D’Angelica, Andrew R. Reynolds, Michail Doukas, Christine Desmedt, Luc Dirix, Vincent Donckier, Peter M. Siegel, Raymond Barnhill, Marco Gerling, Cornelis Verhoef, Peter B. Vermeulen*

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

5 Citations (Scopus)


The first consensus guidelines for scoring the histopathological growth patterns (HGPs) of liver metastases were established in 2017. Since then, numerous studies have applied these guidelines, have further substantiated the potential clinical value of the HGPs in patients with liver metastases from various tumour types and are starting to shed light on the biology of the distinct HGPs. In the present guidelines, we give an overview of these studies, discuss novel strategies for predicting the HGPs of liver metastases, such as deep-learning algorithms for whole-slide histopathology images and medical imaging, and highlight liver metastasis animal models that exhibit features of the different HGPs. Based on a pooled analysis of large cohorts of patients with liver-metastatic colorectal cancer, we propose a new cut-off to categorise patients according to the HGPs. An up-to-date standard method for HGP assessment within liver metastases is also presented with the aim of incorporating HGPs into the decision-making processes surrounding the treatment of patients with liver-metastatic cancer. Finally, we propose hypotheses on the cellular and molecular mechanisms that drive the biology of the different HGPs, opening some exciting preclinical and clinical research perspectives.

Original languageEnglish
Pages (from-to)988-1013
Number of pages26
JournalBritish Journal of Cancer
Issue number6
Publication statusPublished - 5 Oct 2022

Bibliographical note

Funding Information:
The work by CD, PV, GF, VD, LD and DL on breast cancer liver metastasis is supported by the Foundation against Cancer (Stichting tegen Kanker, Grant C/2020/1441). PV and LD are supported by the Koning Boudewijnstichting. GF is a recipient of a post-doctoral mandate sponsored by the KOOR from the University Hospitals Leuven. PS is a William Dawson Scholar of McGill University and acknowledges funding from the Canadian Institutes of Health Research (CIHR: MOP-136907; PJT-175088). HN is supported by the Swedish Research Council, Wallenberg Foundations/Knut and Alice Wallenberg Foundation, Region Västerbotten, the Swedish Cancer Society, the Cancer Research Foundation in Northern Sweden and Umeå University. MG is supported by The Swedish Research Foundation (2018–02023) and The Swedish Association for Medical Research. QZ is supported by Engineering and Physical Sciences Research Council (project EP/N034708/1). DGM is supported by the Fondo de Investigaciones Sanitarias of the Spanish Government, Fondo Europeo de Desarrollo Regional (FEDER) “Una manera de hacer Europa”/“A way of shaping Europe” (grant PI18/1140) and by AGAUR Department of Health of the Generalitat de Catalunya (grant SGR771). WRJ is supported by grant U01 CA238444–02 from the National Cancer Institute.

Publisher Copyright: © 2022, The Author(s), under exclusive licence to Springer Nature Limited.


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