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doi: https://doi.org/10.4132/jptm.2017.12.27    [Epub ahead of print]
Prognostic Utility of Histological Growth Patterns of Colorectal Lung Oligometastases
Son Jae Yeong1, Min Gyoung Pak1, Hyoun Wook Lee2, Seung Yeon Ha3, Mee Sook Roh1
1Department of Pathology, Dong-A University College of Medicine, Busan, Korea
2Department of Pathology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
3Department of Pathology, Gachon University of Medicine and Science, Incheon, Korea
Corresponding Author: Mee Sook Roh ,Tel: +82-51-240-2833, Fax: +82-51-243-7396, Email: msroh@dau.ac.kr
Received: August 20, 2017;  Revised: December 10, 2017  Accepted: December 27, 2017.  Published online: February 12, 2018.

Patients with resectable colorectal lung oligometastases demonstrate a heterogeneous oncological outcome. However, the parameters for predicting tumor aggressiveness have not yet been fully investigated in colorectal lung metastases (CLM). This study was performed to determine the prognostic value of histological growth patterns in patients who underwent surgery for CLM.
The study included 92 patients who were diagnosed with CLM among the first resection cases. CLMs grow according to three histological patterns: aerogenous, pushing, and desmoplastic patterns. The growth patterns were evaluated on archival hematoxylin and eosin-stained tissue sections.
The aerogenous pattern was found in 29.4% (n=27) of patients, the pushing pattern in 34.7% (n=32), the desmoplastic pattern in 6.5% (n=6), and a mix of two growth patterns in 29.4% (n=27). The size of the aerogenous pattern was significantly smaller than that of metastases with other patterns (p=.033). Kaplan-Meier analysis demonstrated that patients showing an aerogenous pattern appeared to have a poorer prognosis, which was calculated from the time of diagnosis of the lung metastasis (p=.044). The 5-year survival rate from the diagnosis of colorectal cancer tended to be lower in patients with an aerogenous pattern than in those who had a non-aerogenous pattern; however, the difference was marginally significant (p=.051). In the multivariate Cox analysis, the aerogenous pattern appeared as an independent predictor of poor overall survival (hazard ratio, 3.122; 95% confidence interval, 1.196 to 8.145; p=.02).
These results suggest that the growth patterns may play a part as a histology-based prognostic parameter for patients with CLM.
Key Words: Colorectal neoplasms; Lung; Oligometastasis; Growth pattern; Prognosis
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