Computed tomographic findings of colorectal liver metastases can be predictive for recurrence after hepatic resection

Abstract

Background: We recently reported that the pathologic mode of infiltrative growth (infiltrative [INF]-alpha, INF-beta, and INF-gamma) of colorectal liver metastases had characteristic morphologic findings, and furthermore showed that the INF type was a prognostic factor for disease-free survival after hepatic resection.

Hypothesis: Preoperative computed tomographic (CT) findings of the liver nodules may be predictive for pathologic tumor growth pattern.

Design: Retrospective study.

Setting: Departments of Surgery and Radiology at a university hospital in Japan.

Patients: A total of 25 CT examinations (1985-1998) were reviewed, and a comparison was conducted on CT findings of 2 groups with INF-alpha or INF-beta (hereafter noted as INF-alpha-beta) (n = 9 [ie, a patient with INF-alpha plus 8 with INF-beta]) and INF-gamma (n = 16) type liver metastases.

Main outcome measures: chi(2) Analysis of CT morphologic features was performed between the study groups. The result of multivariate analysis was obtained using the Cox proportional hazards model.

Results: The morphologic features observed by CT showed a significant difference between the 2 groups (INF-alpha-beta, and INF-gamma types) in the ratio of length to breadth of nodules (<1.5 vs > or =1.5, P =.008) and in the outline of nodules (regular vs irregular, P =.01). Of these CT imaging features, the outline of the nodule was an independent prognostic factor (P =.02).

Conclusion: Computed tomographic findings of colorectal liver lesions correlated with the pathologic tumor growth pattern and a prognosis.