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Histopathological Growth Patterns Determine the Outcomes of Colorectal Cancer Liver Metastasis Following Liver Resection
by
, , and
Lucyna Krzywoń
1,2, 
Anthoula Lazaris
1
,
Stephanie K. Petrillo
1,
Oran Zlotnik
1,2,
Zu-Hua Gao
1,3,4 and
Peter Metrakos
1,4,*
1
Cancer Research Program, Research Institute of McGill University Health Center Glen Site, McGill University Health Center, Royal Victoria Hospital-Glen Site, 1001 Decarie Blvd Room E02.6218, Montreal, QC H4A 3J1, Canada
2
Department of Experimental Surgery, McGill University, 1650 Cedar Ave., Room A7.117, Montreal, QC H4A 3J1, Canada
3
Department of Pathology and Labaratory Medicine, University of British Columbia, Rm. G227-2211 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada
4
McGill University Health Center, Royal Victoria Hospital-Glen Site, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada
*
Author to whom correspondence should be addressed.
Cancers 2024, 16(18), 3148; https://doi.org/10.3390/cancers16183148
Submission received: 23 July 2024
/
Revised: 14 August 2024
/
Accepted: 17 August 2024
/
Published: 13 September 2024
(This article belongs to the Special Issue Liver Metastasis of Cancer)
Simple Summary
The survival of patients with colorectal cancer liver metastasis can be prognosticated based on the presence or absence of desmoplastic histopathologic growth patterns. Patient survival is improved if the liver tumor has at least a 50% desmoplastic histopathologic growth pattern. Determing the patients tumor histopathological features is essential to prognosis outcomes and treatment management.
Abstract
Introduction: Colorectal cancer liver metastasis (CRCLM) remains a lethal diagnosis, with an overall 5-year survival rate of 5–10%. Two distinct histopathological growth patterns (HGPs) of CRCLM are known to have significantly differing rates of patient survival and response to treatment. We set out to review the results of 275 patients who underwent liver resection for CRCLM at the McGill University Health Center (MUHC) and analyze their clinical outcome, mutational burden, and pattern of cancer progression in light of their HGPs, and to consider their potential effect on surgical decision making. Methods: We performed a retrospective multivariate analysis on clinical data from patients with CRCLM (n = 275) who underwent liver resection at the McGill University Health Center (MUHC). All tumors were scored using international consensus guidelines by pathologists trained in HGP scoring. Results: A total of 109 patients (42.2%) were classified as desmoplastic and angiogenic, whereas 149 patients (57.7%) were non-desmoplastic and vessel co-opting. The 5-year survival rates for angiogenic patients compared with vessel co-opting patients were 47.1% and 13%, respectively (p < 0.0001). Multivariate analysis showed patients with vessel co-opting CRCLM had a higher incidence of extrahepatic metastatic disease (p = 0.0215) compared with angiogenic CRCLM. Additionally, KRAS mutation status was a marker of increased likelihood of disease recurrence (p = 0.0434), as was increased number of liver tumors (p = 0.0071) and multiple sites of extrahepatic metastatic disease (p < 0.0001). Conclusions: Multivariate analysis identified key clinical prognostic and molecular features correlating with the two HGPs. Determining liver tumor HGPs is essential for patient prognostication and treatment optimization.
