Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases

Background: Progress in the treatment of hepatic colorectal metastases (HCRM) demands pathologic indicators of therapy response. We observed that a majority of residual tumor cells are seen at the tumor-normal interface (TNI) in resected HCRM specimens and hypothesized that tumor thickness at the TN...

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التفاصيل البيبلوغرافية
المؤلف الرئيسي: Maru, Dipen (author)
مؤلفون آخرون: Kopetz, Scott (author), Boonsirikamcha, Piyaporn (author), Agarwal, Atin (author), Chun, Yun Shin (author), Wang, Huamin (author), Abdalla, Eddie (author), Kaur, Harmeet (author), Charnsangavej, Chusilp (author), Vauthey, Jean-Nicolas (author), Loyer, Evelyne (author)
التنسيق: article
منشور في: 2010
الوصول للمادة أونلاين:http://hdl.handle.net/10725/2620
http://dx.doi.org/10.1097/PAS.0b013e3181eb2f7b
http://journals.lww.com/ajsp/Abstract/2010/09000/Tumor_Thickness_at_the_Tumor_normal_Interface__A.7.aspx
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author Maru, Dipen
author2 Kopetz, Scott
Boonsirikamcha, Piyaporn
Agarwal, Atin
Chun, Yun Shin
Wang, Huamin
Abdalla, Eddie
Kaur, Harmeet
Charnsangavej, Chusilp
Vauthey, Jean-Nicolas
Loyer, Evelyne
author2_role author
author
author
author
author
author
author
author
author
author
author_facet Maru, Dipen
Kopetz, Scott
Boonsirikamcha, Piyaporn
Agarwal, Atin
Chun, Yun Shin
Wang, Huamin
Abdalla, Eddie
Kaur, Harmeet
Charnsangavej, Chusilp
Vauthey, Jean-Nicolas
Loyer, Evelyne
author_role author
dc.creator.none.fl_str_mv Maru, Dipen
Kopetz, Scott
Boonsirikamcha, Piyaporn
Agarwal, Atin
Chun, Yun Shin
Wang, Huamin
Abdalla, Eddie
Kaur, Harmeet
Charnsangavej, Chusilp
Vauthey, Jean-Nicolas
Loyer, Evelyne
dc.date.none.fl_str_mv 2010
2015-11-19T08:59:21Z
2015-11-19T08:59:21Z
2015-11-19
dc.identifier.none.fl_str_mv 0147-5185
http://hdl.handle.net/10725/2620
http://dx.doi.org/10.1097/PAS.0b013e3181eb2f7b
Maru, D. M., Kopetz, S., Boonsirikamchai, P., Agarwal, A., Chun, Y. S., Wang, H., ... & Loyer, E. M. (2010). Tumor thickness at the tumor-normal interface: a novel pathologic indicator of chemotherapy response in hepatic colorectal metastases. The American journal of surgical pathology, 34(9), 1287-1294.
http://journals.lww.com/ajsp/Abstract/2010/09000/Tumor_Thickness_at_the_Tumor_normal_Interface__A.7.aspx
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv The Amercan Journal of Surgical Pathology
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description Background: Progress in the treatment of hepatic colorectal metastases (HCRM) demands pathologic indicators of therapy response. We observed that a majority of residual tumor cells are seen at the tumor-normal interface (TNI) in resected HCRM specimens and hypothesized that tumor thickness at the TNI correlates with radiologic and pathologic response and recurrence-free survival (RFS). Design: This study included 103 patients with HCRM resected after preoperative chemotherapy with or without bevacizumab. Imaging response was assessed by response evaluation criteria in solid tumors (RECIST) and recently described CT morphology criteria by Chun et al. The pathologic response was categorized as complete (no tumor cells), major (<50% residual tumor cells), or minor (≥50% residual tumor cells). The maximum thickness of uninterrupted layers of tumor cells was measured perpendicular to the TNI by 2 pathologists independently, followed by consensus review for discrepant cases. For specimens containing >1 tumor, the average tumor thickness at the TNI was used. Results: Sixty-five patients received oxaliplatin-based chemotherapy, 38 received irinotecan-based chemotherapy, and 75 received concurrent bevacizumab. A complete pathologic response was seen in 9 patients, a major response in 44, and a minor response in 50. Median tumor thickness at the TNI was 2.8 mm (interquartile range, 0.5 to 6 mm). Tumor thickness correlated better with radiologic response as determined by Chun et al (P<0.0001) than by RECIST criteria (Spearman r=0.35, P<0.001). Tumor thickness correlated with pathologic response (Spearman r=0.80, P<0.0001). Greater thickness predicted shorter recurrence-free survival, and this correlation remained in multivariate analysis (P=0.015). Tumor thickness was smaller in patients treated with bevacizumab than in patients not given bevacizumab (P=0.03). Conclusions: Tumor thickness measured at the TNI is potentially a new prognostic factor for therapy response and survival outcome in patients with resected HCRM.
eu_rights_str_mv openAccess
format article
id LAURepo_0915bdf4dcebb777be229b19112dde09
identifier_str_mv 0147-5185
Maru, D. M., Kopetz, S., Boonsirikamchai, P., Agarwal, A., Chun, Y. S., Wang, H., ... & Loyer, E. M. (2010). Tumor thickness at the tumor-normal interface: a novel pathologic indicator of chemotherapy response in hepatic colorectal metastases. The American journal of surgical pathology, 34(9), 1287-1294.
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
oai_identifier_str oai:laur.lau.edu.lb:10725/2620
publishDate 2010
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repository.name.fl_str_mv
repository_id_str
spelling Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal MetastasesMaru, DipenKopetz, ScottBoonsirikamcha, PiyapornAgarwal, AtinChun, Yun ShinWang, HuaminAbdalla, EddieKaur, HarmeetCharnsangavej, ChusilpVauthey, Jean-NicolasLoyer, EvelyneBackground: Progress in the treatment of hepatic colorectal metastases (HCRM) demands pathologic indicators of therapy response. We observed that a majority of residual tumor cells are seen at the tumor-normal interface (TNI) in resected HCRM specimens and hypothesized that tumor thickness at the TNI correlates with radiologic and pathologic response and recurrence-free survival (RFS). Design: This study included 103 patients with HCRM resected after preoperative chemotherapy with or without bevacizumab. Imaging response was assessed by response evaluation criteria in solid tumors (RECIST) and recently described CT morphology criteria by Chun et al. The pathologic response was categorized as complete (no tumor cells), major (<50% residual tumor cells), or minor (≥50% residual tumor cells). The maximum thickness of uninterrupted layers of tumor cells was measured perpendicular to the TNI by 2 pathologists independently, followed by consensus review for discrepant cases. For specimens containing >1 tumor, the average tumor thickness at the TNI was used. Results: Sixty-five patients received oxaliplatin-based chemotherapy, 38 received irinotecan-based chemotherapy, and 75 received concurrent bevacizumab. A complete pathologic response was seen in 9 patients, a major response in 44, and a minor response in 50. Median tumor thickness at the TNI was 2.8 mm (interquartile range, 0.5 to 6 mm). Tumor thickness correlated better with radiologic response as determined by Chun et al (P<0.0001) than by RECIST criteria (Spearman r=0.35, P<0.001). Tumor thickness correlated with pathologic response (Spearman r=0.80, P<0.0001). Greater thickness predicted shorter recurrence-free survival, and this correlation remained in multivariate analysis (P=0.015). Tumor thickness was smaller in patients treated with bevacizumab than in patients not given bevacizumab (P=0.03). Conclusions: Tumor thickness measured at the TNI is potentially a new prognostic factor for therapy response and survival outcome in patients with resected HCRM.PublishedN/A2015-11-19T08:59:21Z2015-11-19T08:59:21Z20102015-11-19Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0147-5185http://hdl.handle.net/10725/2620http://dx.doi.org/10.1097/PAS.0b013e3181eb2f7bMaru, D. M., Kopetz, S., Boonsirikamchai, P., Agarwal, A., Chun, Y. S., Wang, H., ... & Loyer, E. M. (2010). Tumor thickness at the tumor-normal interface: a novel pathologic indicator of chemotherapy response in hepatic colorectal metastases. The American journal of surgical pathology, 34(9), 1287-1294.http://journals.lww.com/ajsp/Abstract/2010/09000/Tumor_Thickness_at_the_Tumor_normal_Interface__A.7.aspxenThe Amercan Journal of Surgical Pathologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/26202019-02-26T11:16:48Z
spellingShingle Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
Maru, Dipen
status_str publishedVersion
title Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
title_full Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
title_fullStr Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
title_full_unstemmed Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
title_short Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
title_sort Tumor Thickness at the Tumor-normal Interface: A Novel Pathologic Indicator of Chemotherapy Response in Hepatic Colorectal Metastases
url http://hdl.handle.net/10725/2620
http://dx.doi.org/10.1097/PAS.0b013e3181eb2f7b
http://journals.lww.com/ajsp/Abstract/2010/09000/Tumor_Thickness_at_the_Tumor_normal_Interface__A.7.aspx