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KMID : 0371420140870010014
Annals of Surgical Treatment and Research
2014 Volume.87 No. 1 p.14 ~ p.21
Histopathologic factors affecting tumor recurrence after hepatic resection in colorectal liver metastases
Park Min-Su

Yi Nam-Joon
Son Sang-Yong
You Tae
Suh Suk-Won
Choi Young-Rok
Kim Hye-Young
Hong Geun
Lee Kyoung-Bun
Lee Kwang-Woong
Jeong Seung-Yong
Park Kyu-Joo
Suh Kyung-Suk
Park Jae-Gahb
Abstract
Purpose: Hepatic resection is a standard method of treatment for colorectal liver metastases (CRLM). However, the pathologic factors of metastatic lesions that affect tumor recurrence are less well defined in CRLM. The aim of this study was to evaluate the risk factors for recurrence of CRLM, focusing on histopathologic factors of metastatic lesions of the liver.

Methods: From January 2003 to December 2008, 117 patients underwent curative hepatic resection for CRLM were reviewed. Tumor size and number, differentiation, tumor budding, angio-invasion, dedifferentiation and tumor infiltrating inflammation of metastatic lesions were investigated.

Results: The mean number of hepatic tumors was 2 (range, 1-8). The mean size of the largest tumor was 2.9 cm (range, 0.3-18.5 cm) in diameter. The moderate differentiation of the hepatic tumor was the most common in 86.3% of the patients. Tumor budding, angio-invasion, and dedifferentiation were observed in 81%, 34%, and 12.8% of patients. Inflammation infiltrating tumor was detected in 6.8% of patients. Recurrence after hepatic resection appeared in 69 out of 117 cases (58.9%). Recurrence-free survival at 1, 2 and 5 years were 62.4%, 43.6%, and 34.3%. The multivariate analysis showed the number of metastases ¡Ã3 (P = 0.007), the tumor infiltrating inflammation (P = 0.047), and presence of dedifferentiation (P = 0.020) to be independent risk factors for tumor recurrence.

Conclusion: Histopathological factors, i.e., dedifferentiation and tumor infiltrating inflammation of the metastatic lesion, could be one of the risk factors of aggressive behavior as well as the number of metastases even after curative resection for CRLM.
KEYWORD
Colorectal neoplasm, Liver metastasis, Recurrence, Hepatic resection, Inflammation
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