Proposal for novel histological findings of colorectal liver metastases with preoperative chemotherapy.
This study aimed to clarify the histological characteristics related to preoperative chemotherapy for colorectal liver metastases (CRLM). Sixty-three patients with CRLM were divided into two groups: CRLM with chemotherapy (41 cases, group A) and CRLM without chemotherapy (22 cases; surgical treatment alone, group S) to identify the histological differences associated with chemotherapy. In addition, we investigated the effects of combination chemotherapy on the histology of metastatic lesions. Infarct-like necrosis (ILN), three-zonal changes, and cholesterol clefts were more frequent in group A than in group S (P < 0.05). ILN and three-zonal changes were more common in the 5-FU with leucovorin and oxaliplatin (FOLFOX), or 5-FU with leucovorin and irinotecan (FOLFIRI) with or without additional bevacizumab groups than in group S (P < 0.05). Cholesterol clefts in the FOLFOX or FOLFIRI with bevacizumab group and foamy macrophages in the FOLFOX or FOLFIRI group were more common than in group S (P < 0.05). Cases with more than three of the four histological findings--i.e. ILN, three-zonal changes, cholesterol clefts, and foamy macrophages--were more frequent in the FOLFOX or FOLFIRI with or without additional bevacizumab groups than in group S (P < 0.05). We showed histological findings for every representative chemotherapy regimen for CRLM to clarify the effects of preoperative chemotherapy.
Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan.
Kazuyuki
K
Ishida
Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan.
Noriyuki
N
Uesugi
Department of Surgery, Iwate Medical University, Morioka, Japan.
Yasushi
Y
Hasegawa
Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan.
Ryo
R
Sugimoto
Department of Surgery, Iwate Medical University, Morioka, Japan.
Takeshi
T
Takahara
Department of Surgery, Iwate Medical University, Morioka, Japan.
Koki
K
Otsuka
Department of Surgery, Iwate Medical University, Morioka, Japan.
Hiroyuki
H
Nitta
Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan.
Tomonori
T
Kawasaki
Department of Surgery, Iwate Medical University, Morioka, Japan.
Go
G
Wakabayashi
Department of Molecular Diagnostic Pathology, Iwate Medical University, Morioka, Japan.
Tamotsu
T
Sugai
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemotherapy regimen; cholesterol clefts; colorectal liver metastases; foamy macrophages; histological findings; infarct-like necrosis; preoperative chemotherapy; three-zonal changes