Histopathological growth patterns as biomarker for adjuvant systemic chemotherapy in patients with resected colorectal l
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RESEARCH PAPER
Histopathological growth patterns as biomarker for adjuvant systemic chemotherapy in patients with resected colorectal liver metastases Florian E. Buisman1 · Eric P. van der Stok1 · Boris Galjart1 · Peter B. Vermeulen3 · Vinod P. Balachandran2 · Robert R. J. Coebergh van den Braak1 · John M. Creasy2 · Diederik J. Höppener1 · William R. Jarnagin2 · T. Peter Kingham2 · Pieter M. H. Nierop1 · Eran Sadot2 · Jinru Shia4 · Bas Groot Koerkamp1 · Dirk J. Grünhagen1 · Michael D’Angelica2 · Cornelis Verhoef1 Received: 20 March 2020 / Accepted: 21 June 2020 © The Author(s) 2020
Abstract Adjuvant systemic chemotherapy (CTx) is widely administered in patients with colorectal liver metastases (CRLM). Histopathological growth patterns (HGPs) are an independent prognostic factor for survival after complete resection. This study evaluates whether HGPs can predict the effectiveness of adjuvant CTx in patients with resected CRLM. Two main types of HGPs can be distinguished; the desmoplastic type and the non-desmoplastic type. Uni- and multivariable analyses for overall survival (OS) and disease-free survival (DFS) were performed, in both patients treated with and without preoperative chemotherapy. A total of 1236 patients from two tertiary centers (Memorial Sloan Kettering Cancer Center, New York, USA; Erasmus MC Cancer Institute, Rotterdam, The Netherlands) were included (period 2000–2016). A total of 656 patients (53.1%) patients received preoperative chemotherapy. Adjuvant CTx was only associated with a superior OS in non-desmoplastic patients that had not been pretreated (adjusted hazard ratio (HR) 0.52, 95% confidence interval (CI) 0.37–0.73, p
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