Prognostic significance of poorly differentiated clusters and tumor budding in colorectal liver metastases

Background Histomorphological features have been described as prognostic factors after resection of colorectal liver metastases (CLM). The objectives of this study were to assess the prognostic significance of tumor budding (TB) and poorly differentiated clusters (PDC) among CLM, and their associati...

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Published in:Journal of surgical oncology 2018-06, Vol.117 (7), p.1364-1375
Main Authors: Fonseca, Gilton M., de Mello, Evandro S., Faraj, Sheila F., Kruger, Jaime A. P., Coelho, Fabricio F., Jeismann, Vagner B., Lupinacci, Renato M., Cecconello, Ivan, Alves, Venancio A. F., Pawlik, Timothy M., Herman, Paulo
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cancer surgery
Cell Differentiation
colorectal liver metastases
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Colorectal Neoplasms - surgery
Female
Follow-Up Studies
Humans
Liver Neoplasms - mortality
Liver Neoplasms - secondary
Liver Neoplasms - surgery
liver resection
Lymphatic Metastasis
Male
Medical prognosis
Metastasis
Middle Aged
Neoplasm Invasiveness
poorly differentiated cluster
Prognosis
Survival Rate
tumor budding
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Summary:Background Histomorphological features have been described as prognostic factors after resection of colorectal liver metastases (CLM). The objectives of this study were to assess the prognostic significance of tumor budding (TB) and poorly differentiated clusters (PDC) among CLM, and their association with other prognostic factors. Methods We evaluated 229 patients who underwent a first resection of CLM. Slides stained by HE were assessed for TB, PDC, tumor border pattern, peritumoral pseudocapsule, peritumoral, and intratumoral inflammatory infiltrate. Lymphatic and portal invasion were evaluated through D2‐40 and CD34 antibody. Results Factors independently associated with poor overall survival were nodules>4 (P = 0.002), presence of PDC G3 (P = 0.007), portal invasion (P = 0.005), and absence of tumor pseudocapsule (P = 0.006). Factors independently associated with disease‐free survival included number of nodules>4 (P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25017