Tumor growth pattern as predictor of colorectal liver metastasis recurrence

被引:42
|
作者
Pinheiro, Rafael S. [1 ]
Herman, Paulo [1 ]
Lupinacci, Renato M. [1 ]
Lai, Quirino [2 ]
Mello, Evandro S. [3 ]
Coelho, Fabricio F. [1 ]
Perini, Marcos V. [1 ]
Pugliese, Vincenzo [1 ]
Andraus, Wellington [1 ]
Cecconello, Ivan [1 ]
D'Albuquerque, Luiz Carneiro [1 ]
机构
[1] Univ Sao Paulo, Sch Med, Dept Gastroenterol, Hosp Clin, BR-05403900 Sao Paulo, Brazil
[2] Univ Roma La Sapienza, Umberto Policlin Rome 1, Dept Gen Surg & Organ Transplantat, I-00185 Rome, Italy
[3] Univ Sao Paulo, Sch Med, Dept Pathol, BR-05403900 Sao Paulo, Brazil
来源
AMERICAN JOURNAL OF SURGERY | 2014年 / 207卷 / 04期
关键词
Colorectal neoplasms; Colorectal metastasis; Hepatectomy; Pathology; surgical; Recurrence; HEPATIC RESECTION; SURGICAL MARGIN; EXPANDING CRITERIA; PROGNOSTIC-FACTORS; RECTAL-CANCER; IMPACT; RESECTABILITY; HEPATECTOMY; SURVIVAL;
D O I
10.1016/j.amjsurg.2013.05.015
中图分类号
R61 [外科手术学];
学科分类号
摘要
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. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:493 / 498
页数:6
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