Histology and Inmunohistochemical Analisys in Pacients with Liver Metastases for Colorectal Cancer Based on Tissue Microarrays

Abstract

Many studies have analyzed preoperative poor prognostic factors in patients undergoing liver resection for colorectal liver metastases in order to select patients for surgery. However, intraoperative and postoperative factors have been poorly analyzed. The purpose of this study was to establish postoperative prognostic factors by histological and immunohistochemical study (p53, Ki-67, and stem cell markers, CD44, CD133, and CD166) based on the tissue microarray technique (TMA). For this, data from 100 consecutive patients undergoing any liver resection (127 liver resections) for liver metastases from colorectal cancer from January 2004 to August 2008 were retrospectively analyzed (minimum follow-up, 12 months). Patients were managed by a multidisciplinary team. Overall survival rates (OS) 1, 3, and 5 years after hepatectomy were 92%, 48%, and 30% respectively, and disease-free survival rates (DFS) 1, 3, and 5 years after the first hepatectomy were 85%, 42%, and 24% respectively. The conventional histological type was most common (92%), and a good or middle tumor differentiation grade tumor was seen in 91%. Infiltrating growth was seen in 57% of our patients (expansive in 43%), and microsatellites in 17%. A resection margin less than 10 mm, presence of microsatellites more than 5 mm away from the resection margins, and tumor differentiation grade (poorly differentiated/undifferentiated) were found to be significant independent prognostic factors by univariate analysis. Presence of microsatellites more than 5 mm away from the leading edge of tumor was a poor prognostic factor in multivariate analysis. Univariate and multivariate analyses found no immunohistochemical factors associated to recurrence and/or mortality.