Abstract

The purpose of this study was to characterise growth patterns, proteolysis, and angiogenesis in colorectal liver metastases from chemonaive patients with multiple liver metastases. Twenty-four patients were included in the study, resected for a median of 2.6 metastases. The growth pattern distribution was 25.8% desmoplastic, 33.9% pushing, and 21% replacement. In 20 patients, identical growth patterns were detected in all metastases, but in 8 of these patients, a second growth pattern was also present in one or two of the metastases. In the remaining 4 patients, no general growth pattern was observed, although none of the liver metastases included more than two growth patterns. Overall, a mixed growth pattern was demonstrated in 19.3% of the liver metastases. Compared to metastases with pushing, those with desmoplastic growth pattern had a significantly up-regulated expression of urokinase-type plasminogen activator receptor (P = 0.0008). Angiogenesis was most pronounced in metastases with a pushing growth pattern in comparison to those with desmoplastic (P = 0.0007) and replacement growth pattern (P = 0.021). Although a minor fraction of the patients harboured metastases with different growth patterns, we observed a tendency toward growth pattern uniformity in the liver metastases arising in the same patient. The result suggests that the growth pattern of liver metastases is not a random phenomenon.

Highlights

  • Worldwide colorectal cancer (CRC) accounts for 1.2 million new cases per year, and CRC is the third most prevalent cause of cancer-specific death in both genders [1]

  • At the time of diagnosis, 25% of the patients have CRC liver metastases (CRLMs) and additional 50% of patients without initial liver metastases will develop liver metastases during followup [2,3,4]. These patients only survive for a few months [4], while chemotherapy and targeted therapy with Journal of Oncology humanised monoclonal antibody against the vascular endothelial growth factor (VEGF), bevacizumab, have prolonged the median survival to about 20 months [5]

  • The present study does, support earlier findings that linked the metastatic growth pattern to differences in the vascular activity of the CRLM at the invasive front [12, 20]. This is to our knowledge the first study of liver metastasis growth patterns in chemonaive patients resected for multiple CRLM

Read more

Summary

Introduction

Worldwide colorectal cancer (CRC) accounts for 1.2 million new cases per year, and CRC is the third most prevalent cause of cancer-specific death in both genders [1]. At the time of diagnosis, 25% of the patients have CRC liver metastases (CRLMs) and additional 50% of patients without initial liver metastases will develop liver metastases during followup [2,3,4]. Untreated, these patients only survive for a few months [4], while chemotherapy and targeted therapy with. A combination with capecitabine/5-fluorouracil (5-FU), oxaliplatin, and bevacizumab is a common choice of first line treatment, if the tumour is Kras mutated This emphasises the importance of identification of new predictive markers of response to biological treatment

Objectives
Methods
Results
Discussion
Conclusion
Full Text
Paper version not known

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call