Guideline

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

  • British Journal of Cancer volume 117, pages 14271441 (07 November 2017)
  • doi:10.1038/bjc.2017.334
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Abstract

Background:

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.

Methods:

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.

Results:

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).

Conclusions:

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.

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Change history

  • Corrected online 07 November 2017

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Author information

Affiliations

  1. Translational Cancer Research Unit, GZA Hospitals (St Augustinus), Wilrijk-Antwerp, Belgium

    • Pieter-Jan van Dam
    • , Laure-Anne Teuwen
    • , Gert G Van den Eynden
    • , Michelle Van de paer
    • , Luc Y Dirix
    • , Steven Van Laere
    •  & Peter B Vermeulen
  2. Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands

    • Eric P van der Stok
    • , Robert R J Coebergh van den Braak
    • , Boris Galjart
    • , Dirk J Grünhagen
    •  & Cornelis Verhoef
  3. The Finsen Laboratory, Rigshospitalet/BRIC, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark

    • Martin Illemann
  4. Tumour Biology Team, Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK

    • Sophia Frentzas
    • , Andrew R Reynolds
    •  & Peter B Vermeulen
  5. Hepatobiliary Surgery, Sheffield Teaching Hospitals, Sheffield, UK

    • Ali W Majeed
  6. Department of Oncology, Naestved Hospital, Naestved, Denmark

    • Rikke L Eefsen
  7. Department of Surgery, Cancer Research Program, McGill University Health Centre Research Institute, Montreal, QC, Canada

    • Anthoula Lazaris
    • , Peter Metrakos
    •  & Eve Simoneau
  8. Departments of Surgery, Oncology and Medicine, McGill University and the McGill University Health Center Research Institute, Cancer Research Program, Montreal, QC, Canada

    • Maria Celia Fernandez
    • , Roni Rayes
    •  & Pnina Brodt
  9. The Finsen Laboratory and Department of Radiation Biology, Copenhagen University Hospital, University of Copenhagen, Denmark

    • Ole Didrik Laerum
  10. HistoGeneX, Sint-Bavostraat 78-80, Antwerp 2610, Belgium

    • Michelle Van de paer
    • , Mark Kockx
    •  & Peter B Vermeulen
  11. Department of Pathology, Faculty of Medicine, Vrije Universiteit Brussel, Brussels, Belgium

    • Yves Sucaet
  12. Pathomation, Berchem, Belgium

    • Yves Sucaet
  13. Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK

    • Hardeep Singh Mudhar
  14. Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel

    • Michael Schvimer
  15. Department of Surgery, Department of Surgical and Perioperative Sciences, Umeå University, Umeå, Sweden

    • Hanna Nyström
  16. Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK

    • Nigel C Bird
  17. Valencia Institute of Pathology, Catholic University of Valencia, Valencia, Spain

    • Fernando Vidal-Vanaclocha
  18. Department of Pathology and Oncology, McGill University, Montreal, QC, Canada

    • Zu-hua Gao
  19. Early Clinical Development, Innovative Medicines and Early Development, AstraZeneca, Cambridge, UK

    • Andrew R Reynolds

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Competing interests

The authors declare no conflict of interest.

Corresponding authors

Correspondence to Andrew R Reynolds or Peter B Vermeulen.

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