Daniela Falcão1, Henrique Alexandrino2, Rui Caetano Oliveira3, João Martins1, Luís Ferreira4, Ricardo Martins5, Marco Serôdio5, Mónica Martins5, José Guilherme Tralhão5, Maria Augusta Cipriano3, Francisco Castro E Sousa5. 1. Faculdade de Medicina - Universidade de Coimbra, Coimbra, Portugal. 2. Faculdade de Medicina - Universidade de Coimbra, Coimbra, Portugal; Serviço de Cirurgia A - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address: halexandrino123@gmail.com. 3. Serviço de Anatomia Patológica - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. 4. St. Vincent's University Hospital, Dublin, Ireland. 5. Faculdade de Medicina - Universidade de Coimbra, Coimbra, Portugal; Serviço de Cirurgia A - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
Abstract
INTRODUCTION: Liver resection combined with neoadjuvant chemotherapy (NAC) has reported notable results in patients with colorectal liver metastases (CRLM). Tumoral response to NAC is associated with specific histopathologic patterns with prognostic implications. The main objective of this study was to evaluate the influence of pathological findings on overall survival (OS), disease-free survival (DFS) and liver recurrence-free survival (LRFS). PATIENTS AND METHODS: Analysis of clinical and outcome data from 110 patients who underwent first CRLM resection between January 2010 and July 2013. Blinded pathological review of histological material of several parameters: resection margin, tumor regression grade (TRG), tumor thickness at the tumor-normal interface (TTNI) and the growth pattern (GP). RESULTS: The median survival following hepatic resection was 52 months and 3- and 5- year Kaplan-Meier estimates were 69 and 48%, respectively. Seventy-four patients developed recurrent disease. Oxaliplatin-based chemotherapy was significantly associated with a pushing GP. A positive resection margin was an independent predictor of decreased DFS (p = 0.018) but not of decreased OS. LRFS was strongly reduced by the absence of histologic tumor response (p = 0.018). The pushing pattern had an adverse impact on both OS (p = 0.007) and DFS (p = 0.004) on multivariate analysis. CONCLUSION: The prognostic value of histopathological features in patients who underwent CRLM's resection is undeniable. The pushing GP was related with worse prognosis. Further studies are required to clarify the biological mechanisms underlying these findings in order to enhance a more personalized and efficient treatment of these patients.
INTRODUCTION: Liver resection combined with neoadjuvant chemotherapy (NAC) has reported notable results in patients with colorectal liver metastases (CRLM). Tumoral response to NAC is associated with specific histopathologic patterns with prognostic implications. The main objective of this study was to evaluate the influence of pathological findings on overall survival (OS), disease-free survival (DFS) and liver recurrence-free survival (LRFS). PATIENTS AND METHODS: Analysis of clinical and outcome data from 110 patients who underwent first CRLM resection between January 2010 and July 2013. Blinded pathological review of histological material of several parameters: resection margin, tumor regression grade (TRG), tumor thickness at the tumor-normal interface (TTNI) and the growth pattern (GP). RESULTS: The median survival following hepatic resection was 52 months and 3- and 5- year Kaplan-Meier estimates were 69 and 48%, respectively. Seventy-four patients developed recurrent disease. Oxaliplatin-based chemotherapy was significantly associated with a pushing GP. A positive resection margin was an independent predictor of decreased DFS (p = 0.018) but not of decreased OS. LRFS was strongly reduced by the absence of histologic tumor response (p = 0.018). The pushing pattern had an adverse impact on both OS (p = 0.007) and DFS (p = 0.004) on multivariate analysis. CONCLUSION: The prognostic value of histopathological features in patients who underwent CRLM's resection is undeniable. The pushing GP was related with worse prognosis. Further studies are required to clarify the biological mechanisms underlying these findings in order to enhance a more personalized and efficient treatment of these patients.
Authors: L Viganò; B Branciforte; V Laurenti; G Costa; F Procopio; M Cimino; D Del Fabbro; L Di Tommaso; G Torzilli Journal: Ann Surg Oncol Date: 2022-06-10 Impact factor: 4.339
Authors: Emily Latacz; Diederik Höppener; Ali Bohlok; Vincent Donckier; Peter M Siegel; Raymond Barnhill; Marco Gerling; Cornelis Verhoef; Peter B Vermeulen; 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 Petrillo; Sophie 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 Journal: Br J Cancer Date: 2022-06-01 Impact factor: 9.075
Authors: Maria José Temido; Rui Caetano Oliveira; Ricardo Martins; Marco Serôdio; Beatriz Costa; César Carvalho; Eva Santos; Luís Ferreira; Paulo Teixeira; Maria Augusta Cipriano; José Guilherme Tralhão; Henrique Alexandrino Journal: Cancer Manag Res Date: 2020-11-17 Impact factor: 3.989
Authors: Gemma Garcia-Vicién; Artur Mezheyeuski; Patrick Micke; Núria Ruiz; José Carlos Ruffinelli; Kristel Mils; María Bañuls; Natàlia Molina; Ferran Losa; Laura Lladó; David G Molleví Journal: Cancers (Basel) Date: 2022-01-29 Impact factor: 6.639