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Clinico‐metabolic characterization improves the prognostic value of histological growth patterns in patients undergoing surgery for colorectal liver metastases
Author(s) -
Bohlok Ali,
Duran Derijckere Ivan,
Azema Hugues,
Lucidi Valerio,
Vankerckhove Sophie,
Hendlisz Alain,
Van Laethem Jean Luc,
Vierasu Irina,
Goldman Serge,
Flamen Patrick,
Larsimont Denis,
Demetter Pieter,
Dirix Luc,
Vermeulen Peter,
Donckier Vincent
Publication year - 2021
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26466
Subject(s) - medicine , metabolic activity , colorectal cancer , overall survival , positron emission tomography , gastroenterology , surgery , radiology , cancer , physiology
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.