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Updated: Jan 29, 2026
The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
Background Liver Fibrosis as a Microenvironmental Risk Factor for Intrahepatic Recurrence in Colorectal Liver
Satoru Morita1, Koji Okabayashi2, Yutaka Endo1,3
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Background:
Colorectal cancer liver metastases (CRLMs) are a frequent pattern of recurrence, yet the prognostic impact of background liver fibrosis remains unclear. This study aimed to quantitatively assess hepatic fibrosis histologically and determine its association with intrahepatic recurrence after resection.
Methods:
Patients who underwent hepatic resection for CRLM between 1999 and 2022 were retrospectively included in this study. Background liver fibrosis was evaluated histologically and quantified via whole-slide imaging. Fibrosis was analyzed as a continuous variable using Cox proportional hazards modeling. Additionally, patients were stratified into two groups (fibrosis vs non-fibrosis) using a cutoff determined by receive operating characteristic (ROC) analysis.
Results:
Among 102 patients, 24 (23.5%) were classified into the fibrosis group. Intrahepatic recurrence after hepatic surgery occurred for 36.3% of all the patients, with a significantly higher rate in the fibrosis group than in the non-fibrosis group (58.3% vs 29.5%; p = 0.019), whereas no significant differences were observed in extrahepatic recurrence between the groups (41.7% vs 43.6%; p = 1.0). In the multivariable analysis, fibrotic area percentage was independently associated with intrahepatic recurrence (hazard ratio, 1.45; 95% confidence interval, 1.06-1.98; p = 0.02), demonstrating a linear relationship between fibrosis extent and recurrence risk.
Conclusion:
Histopathologically quantified background liver fibrosis is an independent risk factor for intrahepatic recurrence after CRLM resection. These findings underscore the potential role of the liver microenvironment in tumor recurrence and support further studies exploring hepatic fibrosis as a biomarker for postoperative risk stratification.
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