The histological growth pattern of colorectal cancer liver metastases has prognostic value

Eynden, Gert G. Van den; Bird, Nigel C.; Majeed, Ali W.; Laere, Steven Van; Dirix, Luc; Vermeulen, Peter B.

doi:10.1007/s10585-012-9469-1

Cited by 114 publications

(111 citation statements)

References 22 publications

Supporting

Mentioning

101

Contrasting

Order By: Relevance

“…The present findings conflict with a study conducted by Van den Eynden et al, 3 which evaluated an older cohort of 205 patients hepatectomized for colorectal liver metastases in the period 1995-2005. In this study, no differences in overall survival were found across the growth patterns, yet pushing growth corresponded with poor 2-year survival.…”

Section: Figurecontrasting

confidence: 99%

“…In this study, no differences in overall survival were found across the growth patterns, yet pushing growth corresponded with poor 2-year survival. 3 Although survival in all was markedly better in our study, we found a considerably poorer median survival for patients with replacement-type metastases than Van den Eynden et al, 3 in spite of improved medical and surgical management. In addition, the prevalence of the replacement pattern was lower in our population.…”

Section: Figurecontrasting

confidence: 64%

“…In both studies, desmoplastic encapsulation appeared as a marker of favorable outcome. 3 The findings obtained in the current study indicate a particularly aggressive or treatment resistant tumor biology of replacement-type metastases. One reason for this could be that metastases with a replacement-type margin gain an advantage by incorporating supporting structures endogenous to the liver.…”

Section: Figurementioning

confidence: 54%

“…[1][2][3][4] The desmoplastic growth pattern is consistent with high proteolytic activity. 4,5 Although the morphological categorization described by Vermeulen et al 3 has been recognized in various studies, the prognostic significance remains controversial.…”

mentioning

confidence: 62%

“…Metastases with mixed-type margins have been reported earlier, but guidelines for cut-off point and categorization have not yet been published. [1][2][3][4] In previous studies, little intra-and inter-observer variability was found for Vermeulen's procedure. 1,2,4 After consensus readings by two observers (KN and BV) of 20 cases, one observer (KN) assessed all sections.…”

Section: Histological Assessmentmentioning

confidence: 89%

See 4 more Smart Citations

The morphological growth patterns of colorectal liver metastases are prognostic for overall survival

et al. 2014

View full text Add to dashboard Cite

Colorectal metastases in the liver grow according to three histological patterns: a pushing pattern, a replacement pattern, and a desmoplastic pattern. The objective of the current study was to explore the prognostic significance of these three growth patterns for survival. The study included 217 consecutive patients, liver resected between 2007 and 2011 due to hepatic metastases from colorectal adenocarcinoma. The growth patterns were assessed on archival hematoxylin and eosin-stained tissue sections. In 150 metastases, the density of the immune cell infiltrate at the tumor periphery was judged by a semi-quantitative method. The prevalence of the pushing-type, the desmoplastic-type, and the replacement-type was 33%, 32%, and 11%, respectively; 24% of the metastases displayed a mixed pattern. Kaplan-Meier analysis and Cox regression demonstrated a prognostic significance of the growth patterns (P ¼ 0.0006, log-rank test), as the replacement pattern appeared as an independent predictor of poor overall survival. For patients with replacement growth, the hazard of death was 2-2.5 times higher than for patients with pushing growth (P ¼ 0.004, cox regression) or mixed growth (P ¼ 0.01), and nearly four times higher than for patients with desmoplastic growth (Po0.0001). The negative prognostic effect of the replacement growth pattern was even more pronounced after adjusting for tumor size. Desmoplastic growth corresponded with small tumor size, dense lymphocytic infiltration and a more favorable prognosis. Eventually, the growth patterns may contribute to a histology-based prognostic biomarker for patients with colorectal liver metastases. Modern Pathology (2014) 27, 1641-1648; doi:10.1038/modpathol.2014.4; published online 23 May 2014Keywords: colorectal cancer; growth pattern; histopathology; liver; metastasis; prognosis; survival During the last 5-10 years, major advances have been made in both the medical and surgical treatment of liver metastases from colorectal carcinoma. The number of patients who undergo liver resection with curative intent has therefore increased significantly. However, so far, little is known on the biological, clinical, and histopathological features that determine prognosis after hepatic resection. The revised and more active treatment strategy has thus fostered a demand for new and better prognostic and predictive markers that can be used for selecting the right treatment regimen for each patient. For primary colorectal cancer, the malignant transformation from adenoma to carcinoma is by now very well described; far less described are the events that govern the progression of metastases in the liver. A greater understanding of the diverse infiltration mechanisms of the metastases, including the intricate interaction with the hepatic microenvironment, might lead to new prognostic and therapeutic prospects.Vermeulen et al 1 identified three histological growth patterns for colorectal liver metastases, suggesting biological differences: (i) a pushing growth pattern, in which the metastasis e...

show abstract

Section: Figurecontrasting

confidence: 99%

Section: Figurecontrasting

confidence: 64%

Section: Figurementioning

confidence: 54%

mentioning

confidence: 62%

Section: Histological Assessmentmentioning

confidence: 89%

See 3 more Smart Citations

The morphological growth patterns of colorectal liver metastases are prognostic for overall survival

et al. 2014

View full text Add to dashboard Cite

show abstract

Vessel co‐option in primary human tumors and metastases: an obstacle to effective anti‐angiogenic treatment?

et al. 2013

View full text Add to dashboard Cite

Angiogenesis has been regarded as essential for tumor growth and progression. Studies of many human tumors, however, suggest that their microcirculation may be provided by nonsprouting vessels and that a variety of tumors can grow and metastasize without angiogenesis. Vessel co-option, where tumor cells migrate along the preexisting vessels of the host organ, is regarded as an alternative tumor blood supply. Vessel co-option may occur in many malignancies, but so far mostly reported in highly vascularized tissues such as brain, lung, and liver. In primary and metastatic lung cancer and liver metastasis from different primary origins, as much as 10–30% of the tumors are reported to use this alternative blood supply. In addition, vessel co-option is introduced as a potential explanation of antiangiogenic drug resistance, although the impact of vessel co-option in this clinical setting is still to be further explored. In this review we discuss tumor vessel co-option with specific examples of vessel co-option in primary and secondary tumors and a consideration of the clinical implications of this alternative tumor blood supply.Both primary and metastatic tumors use preexisting host tissue vessels as their blood supply. Tumors may grow to a clinically detectable size without angiogenesis and makes them less likely to respond to drugs designed to target the abnormal vasculature produced by angiogenesis, but further studies to explore the biological and clinical implication of these co-opted vessels is needed.

show abstract

Vascularization of colorectal carcinoma liver metastasis: insight into stratification of patients for anti‐angiogenic therapies

Lazaris

Achour

Petrillo

et al. 2018

The Journal of Pathology CR

View full text Add to dashboard Cite

Current treatment for metastatic disease targets angiogenesis. With the increasing data demonstrating that cancer cells do not entirely rely on angiogenesis but hijack the existing vasculature through mechanisms such as co‐option of existing blood vessels, identification of targets has become of utmost importance. Our study looks at the vasculature of chemonaïve and treated colorectal carcinoma liver metastases (CRCLMs) to obtain a basic understanding of the microvessel density, type of vasculature (mature versus immature), and correlation with histopathological growth patterns that demonstrate unique patterns of angiogenesis. We performed immunohistochemistry on chemonaïve sections of desmoplastic histopathological growth pattern (DHGP) and replacement histopathological growth patterns (RHGP) lesions with CD31 [endothelial cell (EC) marker] and CD34/Ki67 double staining, which denotes proliferating ECs. The CD31 stains demonstrated a lower microvascular CD31 +ve capillary density in the DHGP versus RHGP lesions; and integrating both immunostains with CD34/Ki67 staining on serial sections revealed proliferating vessels in DHGP lesions and co‐option of mature existing blood vessels in RHGP lesions. Interestingly, upon treatment with chemotherapy and bevacizumab, the RHGP lesions showed no necrosis whereas the DHGP lesions had almost 100% necrosis of the cancer cells and in most cases there was a single layer of viable cancer cells, just under or within the desmoplastic ring. The survival of these cells may be directly related to spatial location and possibly a different microenvironment, which may involve adhesion to different extracellular matrix components and/or different oxygen/nutrient availability. This remains to be elucidated. We provide evidence that DHGP CRCLMs obtain their blood supply via sprouting angiogenesis whereas RHGP lesions obtain their blood supply via co‐option of existing vasculature. Furthermore current treatment regimens do not affect RHGP lesions and although they kill the majority of the cancer cells in DHGP lesions, there are cells surviving within or adjacent to the desmoplastic ring which could potentially give rise to a growing lesion.

show abstract

The histological growth pattern of colorectal cancer liver metastases has prognostic value

Cited by 114 publications

References 22 publications

The morphological growth patterns of colorectal liver metastases are prognostic for overall survival

The morphological growth patterns of colorectal liver metastases are prognostic for overall survival

Vessel co‐option in primary human tumors and metastases: an obstacle to effective anti‐angiogenic treatment?

Vascularization of colorectal carcinoma liver metastasis: insight into stratification of patients for anti‐angiogenic therapies

Contact Info

Product

Resources

About