Association between the histopathological growth patterns of liver metastases and survival after hepatic surgery in breast cancer patients

Abstract

Currently, there are no markers to identify patients with liver-only or liver-dominant metastases that would benefit from hepatic surgery. Here we characterized histopathological growth patterns (HGPs) of liver metastases in a consecutive series of 36 breast cancer patients who underwent hepatic surgery. Survival analyses showed that the presence of a desmoplastic HGP in the liver metastases (a rim of fibrous tissue separating cancer cells from the liver parenchyma, present in 20 (56%) patients) is independently associated with favorable progression-free and overall survival when compared with the replacement HGP (cancer cells growing into the liver parenchyma, present in 16 (44%) patients).

Fig. 1. Histological growth patterns in liver metastases from breast cancer patients.

a Breast cancer LM with a desmoplastic growth pattern (H&E staining): black double-headed arrows indicate the desmoplastic rim that separates the tumor tissue from the liver parenchyma. b Breast cancer liver metastasis with a replacement growth pattern (H&E staining): the white arrows indicate some of the regions where cancer cells grow into the liver cell plates and replace the hepatocytes. Cancer cells are in contact with the hepatocytes. The yellow asterisks mark two co-opted sinusoidal blood vessels. c Kaplan–Meier curves displaying the PFS probability according to the HGP group. d Kaplan–Meier curves displaying the OS probability according to the HGP group. e Univariate and multivariate Cox regression analyses for PFS. f Univariate and multivariate Cox regression analyses for OS. CI confidence interval, HGP histological growth pattern (D desmoplastic, R replacement), H&E hematoxylin and eosin, LM liver metastasi(e)s, PFS progression-free survival, OS overall survival.