Growth Pattern In Patients Research Articles

Influence of the Rater's Gender on Assessing Facial Beauty in Adult Patients With Vertical and Horizontal Growth Patterns.

Background The evaluation of attractiveness varies from one civilization, culture, and environment to another and between individuals. Gender can also play a role in determining the standards of attractiveness. The purpose of this study was to evaluate the effect of the rater's gender on the assessment of adult facial attractiveness with a vertical and horizontal growth pattern in patients with skeletal Class I malocclusion. Methodology The study sample comprised extraoral photos taken before the treatment of 120 patients (30 males and 30 females in each group) with skeletal Class I malocclusion and vertical and horizontal growth patterns according to the Bjork sum aged between 18 and 25 years. A panel of 30 laypersons (aged 19-25 years with an average age of 23 ± 0.53 years), including raters from both genders, were selected equally using a disproportionate stratified sampling method through a computer-generated list. The raters used the visual analog scale (VAS) to provide a score for each photograph's aesthetic quality. The most attractive group, which received the greatest aesthetic score, and the least attractive group, which received the lowest aesthetic score, were the two groups formed based on each photograph's mean aesthetic scores. Overall, 13 patients were chosen for each group. Subsequently, the average assessment score for every patient photo set was determined. Independent-sample t-tests were employed to ascertain if the raters' gender made a statistically significant difference in assessing patients with vertical and horizontal growth patterns. Results There were statistically significant differences between the gender of raters in evaluating female patients with vertical growth patterns (p < 0.001), where the average rating of the female raters was significantly greater than that of the male raters in evaluating female patients. In addition, there were statistically significant differences between the gender of raters in evaluating female patients with horizontal growth patterns (p = 0.009), where the average rating of the male raters was significantly greater than that of the female raters in evaluating female patients. Conclusions There is a limited effect of the rater's gender in evaluating facial aesthetics. However, the facial features of female patients with long faces are preferred by females more than males, and males are more critical in evaluating these patients. On the other hand, males favor the facial features of female patients with short faces more than females, and females are more critical in evaluating these patients. These results suggest considering patients' personal characteristics with vertical and horizontal growth patterns during diagnosis and treatment planning.

Retrospective Evaluation of the Prognostic Value of Histological Growth Pattern in Patients with Colorectal Peritoneal Metastases Undergoing Curative-Intent Cytoreductive Surgery.

Two distinct histological growth patterns (HGPs) were described in patients with peritoneal metastasis of colorectal cancer origin (PMCRC) with limited Peritoneal Cancer Index (PCI) ≤ 6 who did not receive neoadjuvant chemotherapy (NAC) and were treated with cytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC): pushing HGP (P-HGP) and infiltrating HGP (I-HGP). Patients with dominant P-HGP (> 50%) had significantly better disease-free survival (DFS) and overall survival (OS). We aimed to determine whether these previous observations regarding the prognostic value of HGP in patients with PMCRC with low PCI (≤ 6) are also valid in all operable patients, regardless of whether they received NAC or not and regardless of PCI score. This was a retrospective study including 76 patients who underwent complete CRS ± HIPEC for PMCRC between July 2012 and March 2019. In each patient, up to five of the largest excised peritoneal nodules were analyzed for their tumor-to-peritoneum interface. Correlations between NAC, HGP, and prognosis were further explored. Thirty-seven patients (49%) had dominant P-HGP and 39 (51%) had dominant I-HGP. On univariate analysis, patients with P-HGP ≤ 50% had significantly lower OS than those with dominant P-HGP > 50% (39 versus 60 months; p = 0.014) confirmed on multivariate analysis (hazard ratio 2.4, 95% confidence interval 1.3-4.5; p = 0.006). There were no significant associations between NAC and type of HGP. This study confirms the prognostic value and reproducibility of the two previously reported HGPs in PMCRC. Dominant P-HGP is associated with better DFS and OS in patients undergoing curative-intent CRS ± HIPEC compared with I-HGP, independently of the extent of peritoneal disease burden.

Pulmonary Annulus Growth Pattern in Patients with Tetralogy of Fallot Prior to Surgical Repair.

The size of the pulmonary valve annulus often determines the feasibility of pulmonary valve preservation at the time of intracardiac repair of Tetralogy of Fallot. Currently, there is limited available data regarding the growth pattern and the determining factors that contribute towards pulmonary valve annulus growth. This retrospective study included patients who underwent surgical repair of Tetralogy of Fallot with or without prior palliation. These patients had an echocardiogram at the time of initial diagnosis and a second echocardiogram prior to intracardiac repair. The sizes of the pulmonary annulus, the right and left pulmonary arteries with z-scores were recorded. Patients with improvement in the pulmonary annulus z-scores between the 2 echocardiographic examinations were allocated in Group I (n = 46) and Group II (n = 68) were those with no improvement. A total of 114 patients were included in the study. The right and left pulmonary arteries size and z scores improved significantly between the 2 echocardiograms. Although the median size of the pulmonary annulus increased between the 2 echocardiograms (6 and 7.9 mm; P<0.001), there was no significant change in the z-score (-2.2, -2.34; P = 0.185). Multivariate logistic regression analysis showed that gender, blood group, presence of collaterals, and palliation with Blalock-Taussig shunt had no impact on the improvement in pulmonary annulus z-score. In Tetralogy of Fallot, the pulmonary valve annulus z-score may not change significantly prior to the intracardiac repair. Although in certain subgroups there may be an improvement, there was no specific factor that could be identified and had an influence on this improvement.

Growth patterns of young achondroplasia patients in Korea and predictability of neurosurgical procedures

BackgroundAchondroplasia is an autosomal dominant disorder mainly affecting bony growth, typically resulting in markedly short stature. From a neurosurgical viewpoint, patients sometimes develop spinal cord compression at the narrowed foramen magnum and hydrocephalus. This study aims to construct growth references for height, weight, and head circumference (HC) of young achondroplasia patients in Korea and to evaluate the predictability of the necessity and timing of neurosurgical procedures through growth patterns.MethodsGrowth data were collected from achondroplasia patients who visited our institution between January 2002 and August 2022. First, we constructed percentile growth curves of height, weight, and HC for the patients under 3 years of age with the generalized additive model for location, scale, and shape (GAMLSS). Second, the growth patterns of the patients with hydrocephalus who underwent neurosurgical procedures such as foramen magnum decompression (FMD) and ventriculoperitoneal (VP) shunt were analyzed.ResultsThere were 125 achondroplasia patients, including 67 males and 58 females. Among 125 patients, 46 underwent FMD, and 5 underwent VP shunt. As short stature and macrocephaly were typical characteristics of achondroplasia, the height of achondroplasia was lower than that of the general population, and HC in achondroplasia showed accelerated growth postnatally. There were no significant changes in HC in hydrocephalus patients before they underwent neurosurgical procedures. The influence of hydrocephalus on the growth patterns of HC in achondroplasia seemed insignificant.ConclusionGrowth references for height, weight, and HC in young achondroplasia patients were constructed. It is the first report of growth patterns of achondroplasia in Korea. Unlike other pediatric patients, the diagnosis of hydrocephalus and the necessity of neurosurgical procedures are hard to be predicted with HC in achondroplasia. Neuroimaging should be considered for achondroplasia patients with neurological symptoms.

Growth patterns in patients with mucopolysaccharidosis VII

ObjectiveThis study assessed growth patterns in patients with mucopolysaccharidosis (MPS) VII before enzyme replacement therapy. MethodsHeight, weight, and body mass index (BMI) measurements and Z-scores from patients from three clinical studies were compared with those from CDC healthy population growth charts. Relationships with age/sex and history of non-immune hydrops fetalis (NIHF) were assessed by linear regression and ANOVA, respectively. ResultsAmong 20 enrolled patients with MPS VII, height Z-scores were near normal until 1 year of age but declined thereafter, particularly among males. There was no consistent pattern in weight Z-score. BMI Z-scores were above normal and increased slightly with age among males and were slightly below normal among females. Male patients with a history of NIHF had greater declines in height and weight Z-scores over time versus males without history of NIHF. There was no clear effect of NIHF history on height and weight Z-scores in female patients. ConclusionsIn patients with MPS VII, declines in height Z-score began early in life, particularly among males, while changes in BMI varied by sex. Patients with MPS VII and a history of NIHF had greater declines in height Z-score with age than did patients without a history of NIHF.Clinical trial registration: This retrospective analysis included patients enrolled in an open-label phase 2 study (UX003-CL203; ClinicalTrials.gov, NCT02418455), a randomized, placebo-controlled, blind-start phase 3 study (UX003-CL301; ClinicalTrials.gov, NCT02230566), or its open-label, long-term extension (UX003-CL202; ClinicalTrials.gov, NCT02432144). Requests for individual de-identified participant data and the clinical study report from this study are available to researchers providing a methodologically sound proposal that is in accordance with the Ultragenyx data sharing commitment. To gain access, data requestors will need to sign a data access and use agreement. Data will be shared via secured portal. The study protocol and statistical analysis plan for this study are available on the relevant clinical trial registry websites with the tabulated results.

Cephalometric Assessment of Pharyngeal Airway Dimensions in Sagittal and Vertical Growth Patterns

Setting: Determination of patency of airway in sagittal and vertical growth patterns in patients visiting LUMHS Institute of Dentistry, Jamshoro. Methods: This cross-sectional study took place in the Orthodontic Department, Institute of Dentistry, LUMHS Jamshoro. Patients in the age group of 12 to 28 years were included. All subjects were categorized into two groups: Group 1 consists of patients with vertical growth, and Group 2 consists of patients with horizontal growth. Measurements were done by McNamara analysis; the skeletal type was analyzed using ANB, FMA, and SN-GOGN measurements were plotted on the Y-axis, measuring the angle between the S-N plane and sella-gnathion. Results: A total of 62 patients were studied; their mean age was 20.74+3.36 years. The majority were females 77.4% and males 22.6%. two groups were made according to growth patterns, group 1 consisted of vertical growers and group 2 was of horizontal grower patients. 37.1% of patients were found to have an obstructive lower pharyngeal airway. Mean ANB, FMA, Y-Axis, SN-GOGN, upper pharyngeal airway, and lower pharyngeal airway was 5.42±3.52 degree, 27.90±7.93 degree, 66.31±6.56 degree, 34.24±7.95 degree, 14.5±2.24 mm and 9.2±2.04mm respectively. The results show a positive and negligible correlation between ANB and pharyngeal airways. Conclusion: There was a positive and negligible correlation between sagittal growth patterns and pharyngeal airway, with class II cases having obstructive pharyngeal airway and class III cases having patent pharyngeal airway. Keywords: Patency of Airway, Sagittal, Skeletal Discrepancies, Vertical

Comparison of growth dynamics in different types of MPS: an attempt to explain the causes

BackgroundMucopolysaccharidoses (MPS) are a group of lysosomal storage disorders caused by deficient activity of enzymes responsible for the catabolism of glycosaminoglycans (GAGs), resulting in progressive damage to various tissues and organs. Affected individuals present with skeletal deformities, bone growth impairment, joint stiffness and frequently mental retardation.ResultsThe objective of the study was to summarise over 30 years of observations of the growth dynamics in patients with different types of MPS, performed at the Children’s Memorial Health Institute (CMHI, Warsaw, Poland). A retrospective analysis of anthropometric data collected from 1989 to 2020 was performed for 195 patients with MPS I, MPS II, MPS III, MPS IVA and MPS VI. Mean values for birth body length were statistically significantly greater than in the general population. The mean z-scores for other MPS groups showed that until the 24th month of life, the growth pattern for all patients was similar, and the average z-scores for body height were greater than in reference charts. Afterwards, growth patterns began to differentiate for MPS groups.ConclusionsThe long-term follow up showed that the growth pattern in patients with all types of mucopolysaccharidoses significantly deviates from the general population. Patients with MPS IVA had the most severe growth impairments compared to other patients in the study group. Neuropathic MPS I and II demonstrated severe growth impairments compared to other patients in this study. Patients with MPS III showed the mildest growth impairments compared to other MPS patients and reached the 3rd percentile last.

Quantitative Morphologic Analysis of Cranial Vault in Twist1+/- Mice: Implications in Craniosynostosis.

The haploinsufficiency in the TWIST1 gene encoding a basic helix-loop-helix transcription factor is a cause of one of the craniosynostosis syndromes, Saethre-Chotzen syndrome. Patients with craniosynostosis usually require operative release of affected sutures, which makes it difficult to observe the long-term consequence of suture fusion on craniofacial growth. In this study, we performed quantitative analysis of morphologic changes of the skull in Twist1 heterozygously-deleted mice (Twist1+/-) with micro-computed tomographic images. In Twist1+/- mice, fusion of the coronal suture began before postnatal day 14 and progressed until postnatal day 56, during which morphologic changes occurred. The growth of the skull was not achieved by a constant increase in the measured distances in wild type mice; some distances in the top-basal axis were decreased during the observation period. In the Twist1+/- mouse, growth in the top-basal axis was accelerated and that of the frontal cranium was reduced. In the unicoronal suture fusion mouse, the length of the zygomatic arch of affected side was shorter in the Twist1+/- mouse. In one postnatal day 56 Twist1+/- mouse with bilateral coronal suture fusion, asymmetric zygomatic arch length was identified. The authors'results suggest that measuring the length of the left and right zygomatic arches may be useful for early diagnosis of coronal suture fusion and for estimation of the timing of synostosis, and that more detailed study on the growth pattern of the normal and the synostosed skull could provide prediction of the risk of resynostosis. The data from this study can be useful to better understand the cranial growth pattern in patients with craniosynostosis.

Vascular Deformation Mapping for CT Surveillance of Thoracic Aortic Aneurysm Growth.

Background Aortic diameter measurements in patients with a thoracic aortic aneurysm (TAA) show wide variation. There is no technique to quantify aortic growth in a three-dimensional (3D) manner. Purpose To validate a CT-based technique for quantification of 3D growth based on deformable registration in patients with TAA. Materials and Methods Patients with ascending and descending TAA with two or more CT angiography studies between 2006 and 2020 were retrospectively identified. The 3D aortic growth was quantified using vascular deformation mapping (VDM), a technique that uses deformable registration to warp a mesh constructed from baseline aortic anatomy. Growth assessments between VDM and clinical CT diameter measurements were compared. Aortic growth was quantified as the ratio of change in surface area at each mesh element (area ratio). Manual segmentations were performed by independent raters to assess interrater reproducibility. Registration error was assessed using manually placed landmarks. Agreement between VDM and clinical diameter measurements was assessed using Pearson correlation and Cohen κ coefficients. Results A total of 38 patients (68 surveillance intervals) were evaluated (mean age, 69 years ± 9 [standard deviation]; 21 women), with TAA involving the ascending aorta (n = 26), descending aorta (n = 10), or both (n = 2). VDM was technically successful in 35 of 38 (92%) patients and 58 of 68 intervals (85%). Median registration error was 0.77 mm (interquartile range, 0.54-1.10 mm). Interrater agreement was high for aortic segmentation (Dice similarity coefficient = 0.97 ± 0.02) and VDM-derived area ratio (bias = 0.0, limits of agreement: -0.03 to 0.03). There was strong agreement (r = 0.85, P < .001) between peak area ratio values and diameter change. VDM detected growth in 14 of 58 (24%) intervals. VDM revealed growth outside the maximally dilated segment in six of 14 (36%) growth intervals, none of which were detected with diameter measurements. Conclusion Vascular deformation mapping provided reliable and comprehensive quantitative assessment of three-dimensional aortic growth and growth patterns in patients with thoracic aortic aneurysms undergoing CT surveillance. Published under a CC BY 4.0 license Online supplemental material is available for this article. See also the editorial by Wieben in this issue.

Histopathological growth patterns in patients with advanced nodular lymphocyte-predominant Hodgkin lymphoma treated within the randomized HD18 study: a report from the German Hodgkin Study Group.

We retrospectively investigated histopathological growth patterns in individuals with advanced nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) treated within the randomized HD18 study. In all, 35/60 patients (58%) presented with atypical growth patterns. Patients with atypical growth patterns more often had stage IV disease (P = 0·0354) and splenic involvement (P = 0·0048) than patients with typical growth patterns; a positive positron emission tomography after two cycles of chemotherapy (PET-2) tended to be more common (P = 0·1078). Five-year progression-free survival [hazard ratio (HR) = 0·86; 95% confidence interval (CI) = 0·49-1·47] and overall survival (HR = 0·85; 95% CI = 0·49-1·51) did not differ between the groups after study treatment with PET-2-guided escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone). Thus, advanced NLPHL is often associated with atypical growth patterns but their prognostic impact is compensated by PET-2-guided escalated BEACOPP.

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

Background and ObjectivesThe 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.MethodsIn 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 18Fluorodeoxyglucose/positron emission tomography.ResultsIn 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.ConclusionsCombining the clinico‐metabolic characteristics with the HGP may improve prognostication in patients undergoing surgery for CRLM.

A Comparison of Transverse Palatal Width in Adult Untreated Cleft Palate Patients with Normal Adult Palates: A Pilot Study

Objective: The purpose of this pilot study is to compare the transverse palatal widths in untreated adult cleft palate patients with normal adult patients. Methods and Materials: The study was conducted in Bangladesh recruiting 10 patients with adult sized untreated cleft palate and 15 patients with normal adult sized palates. The control group was comprised of 7 males and 8 females with a mean age of 30.5 ± 4.4 years. The affected group comprised of 7 males and 3 females with a mean age 17 ± 3.3 years. Alginate impressions of the maxillary arch were taken and poured into plaster dental casts. The inter-canine, inter-premolar and intermolar widths were measured to evaluate the maxillary growth pattern in patients with unoperated cleft palate. Due to the small sample size, both independent T-test and Mann Whitney non-parametric tests were performed to analyze the statistical significance of the data. Results: According to both the T-test and Mann Whitney non-parametric tests, the inter-premolar width including both the first and second premolars was statistically significantly smaller in the affected group with p values of 0.003 and 0.00 respectively. There was no significant difference in the inter-canine width between the affected and control group due to the variable canine position in cleft palate patients. Due to small sample size, no significant difference in the intermolar width between the affected and control group could be established. Conclusion: The interpremolar width is significantly smaller in patients with adult sized cleft palates than individuals with normal adult sized palates.

Clonal Dynamics after Venetoclax-Obinutuzumab Therapy: Novel Insights from the Randomized, Phase 3 CLL14 Trial

Clonal Dynamics after Venetoclax-Obinutuzumab Therapy: Novel Insights from the Randomized, Phase 3 CLL14 Trial

Postnatal Brain Growth Patterns in Pontocerebellar Hypoplasia.

Pontocerebellar hypoplasia (PCH) is a rare group of disorders mainly affecting the cerebellum and pons. Supratentorial structures are variably involved. We assessed brain growth patterns in patients with the most frequent forms of PCH, namely PCH1B (OMIM#614678) and PCH2A (OMIM#277470), since in these types of PCH, pre- and postnatal neurodegeneration is established by neuropathological profiling. To assess the influence of the different pathomechanisms on postnatal growth patterns, we included CASK-associated microcephaly and PCH (MICPCH, OMIM#300749) patients in our analyses, as MICPH mimics PCH on magnetic resonance imaging (MRI) but represents a developmental disorder including abnormal neuronal migration. A total of 66 patients were included: 9 patients with PCH1B, 18 patients with PCH2A, 6 patients with MICPCH, and 33 age- and gender-matched hospital-based controls. Segmentation of the vermis and cerebellum was performed manually, as were measurements of the thickness of the head of the caudate nucleus, the width of the anterior horn, and lateral ventricle size. The cerebellum was severely hypoplastic at birth in all patients, and postnatal growth was nearly absent. In patients with PCH1B/2A, we found relative sparing of the vermis compared with the cerebellar hemispheres. In addition, PCH1B and PCH2A cases demonstrated thinning of the head of the caudate nucleus, an associated increase in anterior horn width, and an increase in lateral ventricle size. None of these features were seen in the MICPCH group. Our findings confirm the progressive nature including caudate nucleus atrophy in PCH1B and PCH2A. In MICPCH, the relative sparing of supratentorial structures confirms its different pathomechanism.

998 - Comparison of the efficacy of new laser flow cytometer UF-5000 with UF-1000i in predicting bacteria growth patterns in patients with uncomplicated urinary tract infections

998 - Comparison of the efficacy of new laser flow cytometer UF-5000 with UF-1000i in predicting bacteria growth patterns in patients with uncomplicated urinary tract infections

Prevalence of Average, Horizontal and Vertical Growth Pattern in Patients with Class I Malocclusion -A Retrospective Study

Prevalence of Average, Horizontal and Vertical Growth Pattern in Patients with Class I Malocclusion -A Retrospective Study

Immune phenotype and histopathological growth pattern in patients with colorectal liver metastases

BackgroundPatients with desmoplastic (angiogenic) histopathological growth pattern (HGP) colorectal liver metastases (CLM) might derive more benefit from bevacizumab-based chemotherapy than those with replacement (non-angiogenic) HGP. This study investigated the association of HGP with the immune phenotype (IP) and clinical outcome after liver resection.MethodsCLM of patients treated with perioperative bevacizumab-based chemotherapy and liver resection were investigated. Association of HGP and IP with response, recurrence-free survival (RFS) and overall survival (OS) was investigated.ResultsOne hundred and eighteen patients (M/F 66/52, median age 62.3 (31.0–80.4) years, median follow-up 32.2 (5.0–92.7) months) were enrolled. The inflamed IP was associated with the desmoplastic HGP. The desmoplastic HGP was associated with better radiological and histological response compared to the replacement HGP, respectively. The replacement HGP was associated with shorter RFS (8.7 versus 16.3 months, HR 2.60, P = 0.001) and OS (36.6 months versus not reached, HR 2.32, P = 0.027), respectively. The non-inflamed IP was associated with shorter RFS (10.8 versus 16.5 months, HR 1.85, P = 0.029). The HGP but not the IP remained significant in multivariable analysis for RFS.ConclusionsThe desmoplastic HGP is associated with the inflamed IP and HGP may be a potential biomarker for adjuvant treatment that includes targeting the immune contexture.

374P - Prognostic value of histological growth pattern in patients operated for breast cancer liver metastases

BackgroundSurgery for breast cancer liver metastases (BCLM) remains controversial. Recently, histological growth pattern (HGP), defined as replacement (rHGP) or desmoplastic (dHGP), has been demonstrated of prognostic value in patients operated for colorectal liver metastases. In BCLM, the types of HGP and their prognostic values have not been determined. We aimed to characterize HGPs in a series of patients undergoing liver resection for BCLM and correlate these patterns with postoperative outcomes. MethodsA series of 74 patients operated for BCLM was reviewed. Clinicopathologic variables, overall and disease-free survivals (OS and DFS) were analyzed. HGP could not be evaluated in 37 cases, due to exclusive radiofrequency treatment (N=22), complete pathological response (N=9) or unavailability of tissue sections (N=6). HGP was assessed in archival H&E stained tissue sections, according to international consensus guidelines in 37 patients. The proportions of rHGP and dHGP were determined in each metastasis. Patients were categorized as pure (100% rHGP or dHGP) or dominant phenotype (>50% rHGP or dHGP, on the entire tumor/normal liver interface). In case of multiple metastases, mean HGP was calculated. All these factors were correlated with OS and DFS. ResultsAfter a mean postoperative follow-up of 81 months, 5-years OS and DFS in global population were 49.7% and 22.7%, respectively. No clinicopathologic preoperative factor was found to be predictive for OS or DFS. Among the 37 patients analyzed for HGP, 17 were pure rHGP (46%), 10 dominant rHGP (27%), 9 dominant dHGP (24.3%) and 1 pure dHGP. Five-years OS and DFS were significantly reduced in patients with pure rHGP, respectively of 20.3 and 0% (all patients recurring within 2 years) as compared with patients with any dHGP component, respectively of 63 and 45% (p=0.03 and <0.003). No other parameter (patient, primary tumor and BCLM characteristics) was significantly different between the patients with pure rHGP and those with any dHGP component. ConclusionsIn this series of patients undergoing surgical resection for BCLM, the large majority of metastases displayed pure or dominant rHGP. Pure rHGP appears as a strong negative prognostic factor for postoperative outcome in these patients. Legal entity responsible for the studyVincent Donckier. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Prognostic significance of tumour infiltration growth pattern in patients with advanced gastric cancer

AimsThe prognostic significance of infiltration growth pattern (INF) in patients with gastric cancer (GC) remains controversial. In the present study, we evaluated the impact of INF pattern on the prognosis...

Prognostic and predictive value of the macroscopic growth pattern in patients undergoing curative resection of colorectal cancer: a single-institution retrospective cohort study of 4,080 Chinese patients.

PurposeThe purpose of this study was to determine whether macroscopic growth patterns had an impact on the prognosis of colorectal cancer (CRC) patients with different tumor–node–metastasis (TNM) stages and responses to chemotherapy in stage III patients.Patients and methodsWe retrospectively recruited 4,080 stage I–III CRC patients who underwent curative resection at Shandong Provincial Hospital affiliated to Shandong University. All patients were grouped by macroscopic growth patterns (expansive, infiltrative and ulcerative subtypes), and stage III patients were further divided into chemotherapy and nonchemotherapy groups. Kaplan–Meier methods, univariate and multivariate analyses and subset analyses were performed to assess the overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).ResultsKaplan–Meier survival curves and univariate analyses revealed better OS (HR=0.731; 95% CI=0.584–0.916), CSS (HR=0.714; 95% CI=0.548–0.932) and DFS (HR=0.722; 95% CI=0.602–0.864) in the expansive subtype and worse OS (HR=2.121; 95% CI=1.457–3.088), CSS (HR=2.499; 95% CI=1.664–3.753) and DFS (HR=2.360; 95% CI=1.756–3.170) in the infiltrative subtype. Subset analyses based on the tumor–node–metastasis stage showed that the infiltrative subtype was associated with inferior DFS in stage II (HR=2.357; 95% CI=1.210–4.595) and stage III patients (HR=1.941; 95% CI=1.394–2.702) and inferior OS and CSS in stage III patients (HR=1.805; 95% CI=1.210–2.693 and HR=1.981, 95% CI=1.280–3.065, respectively). In addition, multivariate Cox proportional hazard regression models revealed similar results. Furthermore, in stage III patients, the OS, CSS and DFS in both the expansive and ulcerative subtypes were significantly extended after the administration of chemotherapy (all, P<0.001). However, the OS, CSS and DFS in the infiltrative subtype did not change significantly after the administration of chemotherapy (P=0.486, 0.290 and 0.731, respectively).ConclusionThe macroscopic growth pattern was an independent prognostic factor among stage I–III CRC patients. The infiltrative subtype had the worst prognosis in stage III patients and did not display survival benefits from chemotherapy.