Prognostic impact of intrahepatic lymphatic and microvascular involvement in cases of colorectal liver metastases.

TY - JOUR

T1 - Prognostic impact of intrahepatic lymphatic and microvascular involvement in cases of colorectal liver metastases.

AU - Bockhorn, Maximilian

AU - Sotiropoulos, Georgios

AU - Neuhaus, Jan

AU - Sgourakis, George

AU - Sheu, Sien-Yi

AU - Molmenti, Ernesto

AU - Fingas, Christian

AU - Trarbach, Tanja

AU - Frilling, Andreja

AU - Broelsch, Christoph E

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: The purpose of this study was to evaluate the effect of intrahepatic microvascular and lymphatic infiltration on survival in cases of colorectal liver metastases. MATERIALS AND METHODS: Prospectively collected data of 331 patients were analyzed for microvascular invasion (V), lymphatic infiltration (L), and resection margins (R) with respect to overall and disease-free survival. RESULTS: One-, 3-, and 5-year overall survival rates for R0 resected patients were 89%, 64%, and 39%, respectively. The corresponding survival rates for R1 resected patients were 83%, 42%, and 24% (p <0.001). The sole presence of microvascular invasion (V1) or lymphatic infiltration (L1) was not associated with a diminished overall survival (p > 0.05). However, patients with a combination of L1V1 had a significantly worse overall survival of 68%, 20%, and 0% when compared to L0V0 patients. This difference was not influenced by the status of the resection margin. No other parameter investigated was found to be of predictive value. CONCLUSIONS: The presence of combined lymphatic and vascular invasion (L1V1) constitutes a predictor of poor overall and disease-free survival. This subgroup of patients might benefit from adjuvant strategies such as chemotherapeutic treatment.

AB - OBJECTIVE: The purpose of this study was to evaluate the effect of intrahepatic microvascular and lymphatic infiltration on survival in cases of colorectal liver metastases. MATERIALS AND METHODS: Prospectively collected data of 331 patients were analyzed for microvascular invasion (V), lymphatic infiltration (L), and resection margins (R) with respect to overall and disease-free survival. RESULTS: One-, 3-, and 5-year overall survival rates for R0 resected patients were 89%, 64%, and 39%, respectively. The corresponding survival rates for R1 resected patients were 83%, 42%, and 24% (p <0.001). The sole presence of microvascular invasion (V1) or lymphatic infiltration (L1) was not associated with a diminished overall survival (p > 0.05). However, patients with a combination of L1V1 had a significantly worse overall survival of 68%, 20%, and 0% when compared to L0V0 patients. This difference was not influenced by the status of the resection margin. No other parameter investigated was found to be of predictive value. CONCLUSIONS: The presence of combined lymphatic and vascular invasion (L1V1) constitutes a predictor of poor overall and disease-free survival. This subgroup of patients might benefit from adjuvant strategies such as chemotherapeutic treatment.

KW - Humans

KW - Middle Aged

KW - Treatment Outcome

KW - Prognosis

KW - Disease-Free Survival

KW - Colorectal Neoplasms pathology

KW - Liver Neoplasms drug therapy

KW - Lymphatic System pathology

KW - Microvessels pathology

KW - Neoadjuvant Therapy

KW - Perioperative Care

KW - Humans

KW - Middle Aged

KW - Treatment Outcome

KW - Prognosis

KW - Disease-Free Survival

KW - Colorectal Neoplasms pathology

KW - Liver Neoplasms drug therapy

KW - Lymphatic System pathology

KW - Microvessels pathology

KW - Neoadjuvant Therapy

KW - Perioperative Care

M3 - SCORING: Zeitschriftenaufsatz

VL - 24

SP - 845

EP - 850

JO - INT J COLORECTAL DIS

JF - INT J COLORECTAL DIS

SN - 0179-1958

IS - 7

M1 - 7

ER -