THE RELATIONSHIP BETWEEN HISTOPATHOLOGICAL FINDDINGS OF HEPATIC METASTATIC FOCI OF THE COLORECTAL CANCER AND PROGNOSIS AFTER HEPATECTOMY-A CLINICAL STUDY-

Abstract

A histopathological study of resected livers was conducted in order to clarify the mechanism of recurrence in the residual liver following resection of hepatic metastases of colorectal cancer. The main parameters of the investigation included various type of invasive proliferation such as infiltration into the simusoidal space at the periphery or the presenting portion of the metastatic foci, portal system tumor thrombus, biliary tumor thrombus, and (peri) neural invasion. The relationship between the positive findings rate by pathology, including period, number, and extent of hepatic metastases, and the prognosis after resection of the hepatic metastases was investigated.
Positive findings rates were 82% for sinusoidal infiltration, about 29% for portal thrombus, about 9% for biliary thrombus, and about 5% for (peri) neural invasion. There was no significant difference inthe positive rate by period of hepatic metastases, new micrometastases from the foci of hepatic metastases were considered highly likely, and the prognosis of cases with positive micrometastases was poor compared to cases with negative micrometastases. Such micrometastases are therefore considered an important factor in the recurrence arising in the residual live after resection of hepatic metastases. It is thought that we should select a procedure of resection for metastatic foci of the residual liver and a type of postoperative adjuvant chemotherapy in consideration of these histopathological findings.