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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2020

01-12-2020 | Metastasis | Hepatobiliary Tumors

Prognostic Impact of Budding Grade in Patients With Residual Liver Recurrence of Colorectal Cancer After Initial Hepatectomy

Authors: Takuji Noro, MD, PhD, Makoto Nishikawa, MD, Mayumi Hoshikawa, MD, PhD, Takahiro Einama, MD, PhD, Suefumi Aosasa, MD, PhD, Yoshiki Kajiwara, MD, PhD, Yoshihisa Yaguchi, MD, PhD, Koichi Okamoto, MD, PhD, Eiji Shinto, MD, PhD, Hironori Tsujimoto, MD, PhD, Kazuo Hase, MD, PhD, Hideki Ueno, MD, PhD, Junji Yamamoto, MD, PhD

Published in: Annals of Surgical Oncology | Issue 13/2020

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Abstract

Background

Many patients undergoing hepatectomy for colorectal liver metastases (CRLM) experience recurrence. However, no criteria for screening candidates to undergo repeat hepatectomy (RH) for CRLM have been established. Budding, one form by which colorectal carcinoma malignancies are expressed, is a new pathologic index. This study aimed to analyze prognostic factors, including budding, and to provide criteria for screening candidates to undergo RH for recurrent CRLM.

Methods

Data of 186 consecutive patients who underwent hepatectomy for CRLM between April 2008 and December 2015 were collected. Survival was calculated using the Kaplan–Meier method. Uni- and multivariate analyses were performed to determine factors significantly affecting mortality.

Results

Of 186 patients, 131 experienced recurrence after hepatectomy, with 83 of the 131 patients showing recurrence in the liver, and 52 of these 83 patients undergoing primary surgery at the authors’ institution and having information on budding grade. In the univariate analysis, preoperative chemotherapy, budding grade, extrahepatic metastases, and number of liver metastases at the time of recurrence were associated with overall survival (OS) for the 52 patients. In the multivariate analysis, budding grade and number of liver metastases at the time of recurrence were associated with OS.

Conclusion

The study examined simple prognostic factors that could help to screen patients better for RH. Repeat hepatectomy improved the prognosis for patients with recurrent CRLM. The independent prognostic factors for OS were number of liver metastases at recurrence as a conventional factor and budding grade as a new pathologic factor. With budding used as an index, patients who could benefit from hepatectomy can be screened more precisely.
Literature
1.
Bengmark S, Hafstrom L. The natural history of primary and secondary malignant tumors of the liver. II. The prognosis for patients with hepatic metastases from gastric carcinoma verified by laparotomy and postmortem examination. Digestion. 1969;2:179–86.CrossRef
2.
Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg. 1999;230:309–18; discussion 318–21.CrossRef
3.
Hughes KS, Simon R, Songhorabodi S, et al. Resection of the liver for colorectal carcinoma metastases: a multi-institutional study of patterns of recurrence. Surgery. 1986;100:278–84.PubMed
4.
Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery. 1991;110:13–29.PubMed
5.
Abdalla EK, Vauthey JN, Ellis LM, et al. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases. Ann Surg. 2004;239:818–27; discussion 825–817.CrossRef
6.
de Jong MC, Pulitano C, Ribero D, et al. Rates and patterns of recurrence following curative intent surgery for colorectal liver metastasis: an international multi-institutional analysis of 1669 patients. Ann Surg. 2009;250:440–8.PubMed
7.
Adam R, Bismuth H, Castaing D, et al. Repeat hepatectomy for colorectal liver metastases. Ann Surg. 1997;225:51–62; discussion 60–62.CrossRef
8.
de Jong MC, Mayo SC, Pulitano C, et al. Repeat curative-intent liver surgery is safe and effective for recurrent colorectal liver metastasis: results from an international multi-institutional analysis. J Gastrointest Surg. 2009;13:2141–51.CrossRef
9.
Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan MF. Repeat hepatic resections for metastatic colorectal cancer. Ann Surg. 1994;220:657–62.CrossRef
10.
Kulik U, Bektas H, Klempnauer J, Lehner F. Repeat liver resection for colorectal metastases. Br J Surg. 2013;100:926–32.CrossRef
11.
Petrowsky H, Gonen M, Jarnagin W, et al. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg. 2002;235:863–71.CrossRef
12.
Shaw IM, Rees M, Welsh FK, Bygrave S, John TG. Repeat hepatic resection for recurrent colorectal liver metastases is associated with favourable long-term survival. Br J Surg. 2006;93:457–64.CrossRef
13.
Simmonds PC, Primrose JN, Colquitt JL, Garden OJ, Poston GJ, Rees M. Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer. 2006;94:982–99.CrossRef
14.
Wicherts DA, de Haas RJ, Salloum C, et al. Repeat hepatectomy for recurrent colorectal metastases. Br J Surg. 2013;100:808–18.CrossRef
15.
Jonsson K, Grondahl G, Salo M, Tingstedt B, Andersson R. Repeated liver resection for colorectal liver metastases: a comparison with primary liver resections concerning perioperative and long-term outcome. Gastroenterol Res Pract. 2012;2012:568214.CrossRef
16.
Takahashi S, Inoue K, Konishi M, Nakagouri T, Kinoshita T. Prognostic factors for poor survival after repeat hepatectomy in patients with colorectal liver metastases. Surgery. 2003;133:627–34.CrossRef
17.
Brachet D, Lermite E, Rouquette A, Lorimier G, Hamy A, Arnaud JP. Prognostic factors of survival in repeat liver resection for recurrent colorectal metastases: review of sixty-two cases treated at a single institution. Dis Colon Rectum. 2009;52:475–83.CrossRef
18.
Ishiguro S, Akasu T, Fujimoto Y, et al. Second hepatectomy for recurrent colorectal liver metastasis: analysis of preoperative prognostic factors. Ann Surg Oncol. 2006;13:1579–87.CrossRef
19.
Hase K, Shatney C, Johnson D, Trollope M, Vierra M. Prognostic value of tumor “budding” in patients with colorectal cancer. Dis Colon Rectum. 1993;36:627–35.CrossRef
20.
Ueno H, Konishi T, Ishikawa Y, et al. Prognostic value of poorly differentiated clusters in the primary tumor in patients undergoing hepatectomy for colorectal liver metastasis. Surgery. 2015;157:899–908.CrossRef
21.
Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol. 2015;20:207–39.CrossRef
22.
D’Angelica M, Kornprat P, Gonen M, et al. Effect on outcome of recurrence patterns after hepatectomy for colorectal metastases. Ann Surg Oncol. 2011;18:1096–103.CrossRef
23.
Mutsaerts EL, van Ruth S, Zoetmulder FA, Rutgers EJ, Hart AA, van Coevorden F. Prognostic factors and evaluation of surgical management of hepatic metastases from colorectal origin: a 10-year single-institute experience. J Gastrointest Surg. 2005;9:178–86.CrossRef
24.
Fortner JG. Recurrence of colorectal cancer after hepatic resection. Am J Surg. 1988;155:378–82.CrossRef
25.
Elias D, Lasser P, Hoang JM, et al. Repeat hepatectomy for cancer. Br J Surg. 1993;80:1557–62.CrossRef
26.
Patiutko Iu I, Sagaidak IV, Kotel’nikov AG, Tumanian AO. Repeated resection of liver in primary and metastatic cancer. Khirurgiia Mosk. 1999;3:4–6.
27.
Koelzer VH, Zlobec I, Lugli A. Tumor budding in colorectal cancer: ready for diagnostic practice? Hum Pathol. 2016;47:4–19.CrossRef
Metadata
Title
Prognostic Impact of Budding Grade in Patients With Residual Liver Recurrence of Colorectal Cancer After Initial Hepatectomy
Authors
Takuji Noro, MD, PhD
Makoto Nishikawa, MD
Mayumi Hoshikawa, MD, PhD
Takahiro Einama, MD, PhD
Suefumi Aosasa, MD, PhD
Yoshiki Kajiwara, MD, PhD
Yoshihisa Yaguchi, MD, PhD
Koichi Okamoto, MD, PhD
Eiji Shinto, MD, PhD
Hironori Tsujimoto, MD, PhD
Kazuo Hase, MD, PhD
Hideki Ueno, MD, PhD
Junji Yamamoto, MD, PhD
Publication date
01-12-2020
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 13/2020
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08684-3

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