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International consensus guidelines for scoring the histopathological growth patterns of liver metastasis

2017; Springer Nature; Volume: 117; Issue: 10 Linguagem: Inglês

10.1038/bjc.2017.334

1532-1827

Pieter‐Jan van Dam, Eric P. van der Stok, Laure-Anne Teuwen, Gert G. Van den Eynden, Martin Illemann, Sophia Frentzas, Ali W. Majeed, Rikke Løvendahl Eefsen, Robert R.J. Coebergh van den Braak, Anthoula Lazaris, María Celia Fernández, Boris Galjart, Ole Didrik Lærum, Roni Rayes, Dirk J. Grünhagen, Michelle Van de paer, Yves Sucaet, Hardeep Singh Mudhar, Michael Schvimer, Hanna Nyström, Mark Kockx, Nigel C. Bird, Fernando Vidal‐Vanaclocha, Peter Metrakos, Ève Simoneau, Cornelis Verhoef, Luc Dirix, Steven Van Laere, Zu‐Hua Gao, Pnina Brodt, Andrew R. Reynolds, Peter Vermeulen,

Cholangiocarcinoma and Gallbladder Cancer Studies

Liver metastases present with distinct histopathological growth patterns (HGPs), including the desmoplastic, pushing and replacement HGPs and two rarer HGPs. The HGPs are defined owing to the distinct interface between the cancer cells and the adjacent normal liver parenchyma that is present in each pattern and can be scored from standard haematoxylin-and-eosin-stained (H&E) tissue sections. The current study provides consensus guidelines for scoring these HGPs. Guidelines for defining the HGPs were established by a large international team. To assess the validity of these guidelines, 12 independent observers scored a set of 159 liver metastases and interobserver variability was measured. In an independent cohort of 374 patients with colorectal liver metastases (CRCLM), the impact of HGPs on overall survival after hepatectomy was determined. Good-to-excellent correlations (intraclass correlation coefficient >0.5) with the gold standard were obtained for the assessment of the replacement HGP and desmoplastic HGP. Overall survival was significantly superior in the desmoplastic HGP subgroup compared with the replacement or pushing HGP subgroup (P=0.006). The current guidelines allow for reproducible determination of liver metastasis HGPs. As HGPs impact overall survival after surgery for CRCLM, they may serve as a novel biomarker for individualised therapies.