Archive | 2021
Tumor Vascular Micro-environment of Colorectal Hepatic Metastasis and Chemotherapy Response
Abstract
\n Background: Tumor vascular micro-environment has an important role in tumor progression and metastasis. The objective of this study was to assess the significance of metastatic hepatic tumor vascular micro-environment in relation to the response to the systemic 5-FU-based chemotherapy (FOLFOX or FOLFIRI).Methods: A total of 48 consecutive colorectal cancer (CRC) patients with hepatic metastasis were retrospectively reviewed, and factors, such as metastatic tumor vascular micro-environment, chemotherapy response, and hepatic resection, were analyzed. Tumor angiogenesis was microscopically evaluated by microvessel density (MVD) in sections stained immunochemically with CD34 in patients with hepatic resection. The angiogenesis in tumor micro-environment in association with ring enhancement (RE) on computed tomography (CT) was also examined.Results: Microscopic examination revealed that peripheral RE on CT of the metastatic tumor is associated with tumor angiogenesis by MVD. The overall response rate after 6 courses of first-line chemotherapy for the liver metastasis with RE on CT was 64% (23/36), whereas the response rate without RE was 25% (3/12), which was significantly different, although the survival rate of patients with RE-positive or without RE-negative tumors was not different.Conclusion: The peripheral RE on CT of the metastatic hepatic tumor was associated with the angiogenesis in tumor micro-environment and higher chemotherapy response.