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Background and Objectives  The histological growth pattern (HGP) represents a strong prognostic factor in patients undergoing surgery for colorectal liver metastases (CRLM). We evaluated whether the combination of HGP with clinico‐metabolic parameters could improve its prognostic value.    Methods  In a series of 108 patients undergoing resection of CRLM, the HGP of CRLM was scored according to international guidelines. Baseline clinico‐metabolic clinical status was evaluated using a metabolic‐Clinical Risk Score (mCRS), combining traditional Memorial Sloan Kettering‐CRS parameters with the tumor‐to‐liver glucose uptake ratio as measured with  18 Fluorodeoxyglucose/positron emission tomography.    Results  In patients with desmoplastic HGP (DHGP) CRLM (20% of all patients), 5‐ and 10‐years overall survival (OS) and disease free survival (DFS) were 66% and 43% and 37% and 24.5%, as compared with 35% and 21% and 11% and 11% in the non‐DHGP group ( p  = 0.07 and 0.054). Among DHGP patients, those with a low‐risk mCRS had improved postoperative outcomes, 5‐ and 10‐years OS and DFS reaching 83.3% and 62.5% and 50% and 33%, as compared with 18% and 0% and 0% and 0% in high‐risk mCRS patients ( p  = 0.007 and 0.003). In contrast, mCRS did not influence postoperative survivals in non‐DHGP patients.    Conclusions  Combining the clinico‐metabolic characteristics with the HGP may improve prognostication in patients undergoing surgery for CRLM.

journal of surgical oncology

Clinico‐metabolic characterization improves the prognostic value of histological growth patterns in patients undergoing surgery for colorectal liver metastases