Microinvasion of liver metastases from XXXX : predictive factors and application for determining clinical target volume.

@entity1 @entity5 @entity1735 @entity787 @entity14
OBJECTIVES: This study evaluates the microscopic characteristics of liver metastases from @entity14 (LMCRC) invasion and provides a reference for expansion from gross @entity5 volume (GTV) to clinical targeting volume (CTV). METHODS: Data from 129 LMCRC @entity1 treated by surgical resection at our hospital between January 2008 and September 2009 were collected for study. Tissue sections used for pathology and clinical data were reviewed. @entity1 information used for the study included gender, age, original @entity5 site, number of @entity5 , @entity5 size, levels of @entity787 ( @entity787 ) and @entity1735 antigen 199 (CA199), synchronous or metachronous liver metastases, and whether @entity1 received chemotherapy. The distance of liver microinvasion from the @entity5 boundary was measured microscopically by two senior pathologists. RESULTS: Of 129 @entity1 evaluated, 81 (62.8  %) presented microinvasion distances from the @entity5 boundary ranging between 1.0   -   7.0  mm. A GTV-to-CTV expansion of 5, 6.7, or 7.0  mm was required to provide a 95, 99, or 100  % probability, respectively, of obtaining clear resection margins by microscopic observation. The extent of invasion was not related to gender, age, synchronous or metachronous liver metastases, @entity5 size, CA199 level, or chemotherapy. The extent of invasion was related to original @entity5 site, @entity787 level, and number of @entity5 . A scoring system was established based on the latter three positive predictors. Using this system, an invasion distance less than 3  mm was measured in 93.4  % of @entity1 with a score of  <=1 point, but in only 85.7  % of @entity1 with a score of  <=2 points. CONCLUSIONS: The extent of @entity5 invasion in our LMCRC @entity1 cohort correlated with original @entity5 site, @entity787 level, and number of @entity5 . These positive predictors may potentially be used as a scoring system for determining GTV-to-CTV expansion.
