ArticleHPB : the official journal of the International Hepato Pancreato Biliary Association2018
Pathological diaphragmatic invasion by colorectal liver metastases is associated with RAS mutation, peritoneal recurrence and worse survival.
Article in HPB : the official journal of the International Hepato Pancreato Biliary Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Controlled capnothorax creation for stapled diaphragm resection: a safe maneuver for en-bloc liver and frenic resection without diaphragm opening.Surgical endoscopy · 2026Article
- A Post-surgical Collection Is Not Just a Collection: A Case Report of Colorectal Cancer Metastasis.Cureus · 2025Article
- Genomic Predictors of Recurrence Patterns After Complete Resection of Colorectal Liver Metastases and Adjuvant Hepatic Artery Infusion Chemotherapy.Annals of surgical oncology · 2022Article
- Failure to Cure Patients with Colorectal Liver Metastases: The Impact of the Liver Surgeon.Annals of surgical oncology · 2021Article
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9 authors.
Funding
Abstract
backgroundRisk factors for pathological diaphragmatic invasion from colorectal liver metastases (CRLM) and differences in recurrence patterns and survival between patients with true pathological diaphragmatic invasion versus inflammatory adhesions only remain poorly understood. This study aimed at identifying risk factors for and survival impact of pathological diaphragmatic invasion in patients with CRLM.
methodsPatients with CRLM who underwent hepatectomy with or without diaphragmatic resection from 1998 to 2015 were retrospectively analyzed. Recurrence-free survival (RFS), overall survival (OS), and recurrence patterns were examined according to the presence or absence of pathological invasion.
resultsOf 1860 patients, 70 underwent hepatectomy with diaphragmatic resection and 1799 had hepatectomy only. Among the patients with gross diaphragmatic involvement, 15 (21%) had pathological invasion, and 55 (79%) had inflammatory adhesion only. Multiple tumors (p = 0.019) and RAS mutation (p = 0.047) were significantly associated with pathological invasion. Pathological invasion was associated with a higher incidence of peritoneal recurrence (33% vs. 11%, p = 0.041), worse median RFS (6 months vs. 11 months, p = 0.21) and OS (26 months vs. 51 months, p = 0.046) compared to inflammatory adhesion.
conclusionMultiple tumors and RAS mutant were predictors for pathological diaphragmatic invasion, which was associated with a higher incidence of peritoneal recurrence and worse OS.
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