Abstract
Colorectal cancer is a major health burden and despite the recent advances in healthcare and screening programs, a great percentage of patients already present metastases once their disease is found. In those cases, liver surgery has an essential role, but even with neoadjuvant chemotherapy there is a high rate of intrahepatic recurrence. New prognostic factors are needed in order to decide the best surgical approach considering the biological behavior of the tumors in order to tailor the used therapies, moving towards individualized medicine/treatment. However, the majority of the factors described in literature are expensive, time consuming, and difficult to apply on a daily basis. Histological growth patterns have emerged over the past few years as a reproducible characteristic, an easy to apply one, and with very low costs since it only needs the standard Haematoxylin and Eosin stained slides of observation. In this article, we provide a review of the histological growth patterns of liver metastases and their prognostic significance, biological meaning, and therapeutic importance.
Highlights
The liver is a common site for metastatic dissemination and in some regions of the globe, namely, Europe, secondary liver tumors are far more common than primary [1] ones
Due to the simplicity of this biological characteristic, other studies have assessed this biological behavior in liver metastases of nonintestinal carcinomas, such as breast cancer [31] and uveal melanoma [32], but in these cases there is a predominance of the replacement pattern and a worse prognosis
The different prognoses of the colorectal cancer liver metastases (CRCLM) may represent a new prognostic characteristic that may be related to the primary tumor properties and may be predicted by preoperative imaging, allowing individualized patient care
Summary
The liver is a common site for metastatic dissemination and in some regions of the globe, namely, Europe, secondary liver tumors are far more common than primary [1] ones. Liver transplantation has been used successfully [5]. Regardless of the curative intent, intrahepatic recurrence has been reported in more than 50% of the cases, even with adjuvant chemotherapy [6]. Several retrospective studies have identified these patients’ cohorts with poor prognostic factors such as tumor size, number of lesions, and tumor progression after chemotherapy or shorter interval from primary tumor surgery [7]. None of these are absolute contraindications for hepatic surgery and do not represent the tumor-host interaction that will be required for Journal of Oncology individualized medicine/treatment.
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