Background Liver Fibrosis as a Microenvironmental Risk Factor for Intrahepatic Recurrence in Colorectal Liver...

Area of Science:

• Hepatology and Oncology
• Surgical Pathology
• Cancer Recurrence

Background:

• Colorectal cancer liver metastases (CRLMs) frequently recur, but the prognostic significance of background liver fibrosis is not well understood.
• Assessing hepatic fibrosis is crucial for understanding tumor recurrence patterns after CRLM resection.

Purpose of the Study:

• To quantitatively assess background liver fibrosis histologically.
• To determine the association between hepatic fibrosis and intrahepatic recurrence following CRLM resection.

Main Methods:

• Retrospective analysis of 102 patients who underwent hepatic resection for CRLM (1999-2022).
• Histological quantification of background liver fibrosis using whole-slide imaging.
• Cox proportional hazards modeling and ROC analysis for fibrosis assessment and patient stratification.

Main Results:

• 23.5% of patients had significant liver fibrosis.
• Intrahepatic recurrence was significantly higher in the fibrosis group (58.3%) compared to the non-fibrosis group (29.5%; p=0.019).
• Fibrotic area percentage was an independent predictor of intrahepatic recurrence (HR 1.45, p=0.02).

Conclusions:

• Histopathologically quantified liver fibrosis is an independent risk factor for intrahepatic recurrence post-CRLM resection.
• The liver microenvironment, specifically fibrosis, plays a role in tumor recurrence.
• Hepatic fibrosis may serve as a valuable biomarker for postoperative risk stratification in CRLM patients.