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Am J Surg. 2014 Apr;207(4):493-8. doi: 10.1016/j.amjsurg.2013.05.015. Epub 2013 Oct 7.

Tumor growth pattern as predictor of colorectal liver metastasis recurrence.

Author information

1
Department of Gastroenterology, University of São Paulo Medical School, Hospital das Clínicas, Rua Dr Enéas de Carvalho Aguiar, 255, 9° Andar-sala 9113/9114, CEP 05403-900, São Paulo, Brazil. Electronic address: rsnpinheiro@gmail.com.
2
Department of Gastroenterology, University of São Paulo Medical School, Hospital das Clínicas, Rua Dr Enéas de Carvalho Aguiar, 255, 9° Andar-sala 9113/9114, CEP 05403-900, São Paulo, Brazil.
3
Department of General Surgery and Organ Transplantation, Sapienza University of Rome, Umberto I Policlinic of Rome, Rome, Italy.
4
Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil.

Abstract

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.

KEYWORDS:

Colorectal metastasis; Colorectal neoplasms; Hepatectomy; Pathology; Recurrence; surgical

PMID:
24112674
DOI:
10.1016/j.amjsurg.2013.05.015
[Indexed for MEDLINE]
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