Cancer Management and Research (Nov 2020)

Prognostic Factors After Hepatectomy for Gastric Adenocarcinoma Liver Metastases: Desmoplastic Growth Pattern as the Key to Improved Overall Survival

  • Temido MJ,
  • Caetano Oliveira R,
  • Martins R,
  • Serôdio M,
  • Costa B,
  • Carvalho C,
  • Santos E,
  • Ferreira L,
  • Teixeira P,
  • Cipriano MA,
  • Tralhão JG,
  • Alexandrino H

Journal volume & issue
Vol. Volume 12
pp. 11689 – 11699

Abstract

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Maria José Temido,1,2,* Rui Caetano Oliveira,3– 6,* Ricardo Martins,2,4,5,7 Marco Serôdio,2,7 Beatriz Costa,2,5,7 César Carvalho,7 Eva Santos,2,7 Luís Ferreira,7 Paulo Teixeira,3,8 Maria Augusta Cipriano,3 José Guilherme Tralhão,2,4,5,7 Henrique Alexandrino2,5,7 1Gastroenterology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal; 2Faculty of Medicine, University of Coimbra, Coimbra 3000-548, Portugal; 3Pathology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal; 4Biophysics Institute, Faculty of Medicine, University of Coimbra, Coimbra 3000-548, Portugal; 5Coimbra Institute for Clinical and Biomedical Research (iCBR), Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, University of Coimbra, Coimbra 3000-548, Portugal; 6Faculdade de Medicina da Universidade do Porto, Porto 4200-319, Portugal; 7Department of Surgery, Centro Hospitalar e Universitário de Coimbra, Coimbra 3000-075, Portugal; 8Department Biomedical Laboratory Sciences, ESTeSC- Coimbra Health School, Polytechnic Institute of Coimbra, Coimbra 3046-854, Portugal*These authors contributed equally to this workCorrespondence: Maria José TemidoCentro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra 3004-561, PortugalTel +351 910772166Email [email protected]: Hepatectomy (Hp) is an alternative approach for the treatment of gastric carcinoma liver metastases (GCLM). However, prognostic factors that may assist patient selection are still controversial. Several pathologic features, such as the growth pattern (GP), associated with prognosis in colorectal cancer liver metastases, were never investigated in GCLM. Our principal aim was to assess if the GP has prognostic impact on GCLM.Patients and Methods: Review of the clinical and pathological characteristics of 19 consecutive patients submitted to surgical resection of GCLM with curative intent at our department. Major potential prognostic factors considered were patients’ gender, age, timing and extent of Hp, postoperative course, as well as histopathological characteristics of primary and secondary tumors.Results: Major morbidity occurred in four patients, mortality in one. Median and 5-year overall survival were 17 months and 26.7%, respectively. Ten patients developed recurrent disease and two patients survived more than 10 years. Factors independently associated with overall survival were the absence of major morbidity, distal location of the primary tumor, and desmoplastic GP (p< 0.05).Conclusion: The selection of patients is crucial for the improvement of survival rates of GCLM. Consequently, we demonstrate for the first time that the desmoplastic GP of GCLM is associated with improved outcomes, prompting further research on tumor–host interactions.Keywords: liver metastases, gastric carcinoma, hepatectomy, growth pattern, prognosis

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