Computed tomographic findings of colorectal liver metastases can be predictive for recurrence after hepatic resection.

BACKGROUND We recently reported that the pathologic mode of infiltrative growth (infiltrative [INF]-alpha, INF-beta, and INF-gamma) of colorectal liver metastases had characteristic morphologic findings, and furthermore showed that the INF type was a prognostic factor for disease-free survival after hepatic resection. HYPOTHESIS Preoperative computed tomographic (CT) findings of the liver nodules may be predictive for pathologic tumor growth pattern. DESIGN Retrospective study. SETTING Departments of Surgery and Radiology at a university hospital in Japan. PATIENTS A total of 25 CT examinations (1985-1998) were reviewed, and a comparison was conducted on CT findings of 2 groups with INF-alpha or INF-beta (hereafter noted as INF-alpha-beta) (n = 9 [ie, a patient with INF-alpha plus 8 with INF-beta]) and INF-gamma (n = 16) type liver metastases. MAIN OUTCOME MEASURES chi(2) Analysis of CT morphologic features was performed between the study groups. The result of multivariate analysis was obtained using the Cox proportional hazards model. RESULTS The morphologic features observed by CT showed a significant difference between the 2 groups (INF-alpha-beta, and INF-gamma types) in the ratio of length to breadth of nodules (<1.5 vs > or =1.5, P =.008) and in the outline of nodules (regular vs irregular, P =.01). Of these CT imaging features, the outline of the nodule was an independent prognostic factor (P =.02). CONCLUSION Computed tomographic findings of colorectal liver lesions correlated with the pathologic tumor growth pattern and a prognosis.