gms | German Medical Science

131. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

25.03. - 28.03.2014, Berlin

Artikel

Artikel empfehlen

Tumor containment by immune cells and fibrotic capsule improve survival of patients following resection of colorectal liver metastasis

Meeting Abstract

Suche in Medline nach

  • Stefan M. Brunner - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Rebecca Kesselring - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Christoph Rubner - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Maria Martin - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Tonia Jeiter - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Thomas Boerner - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Petra Ruemmele - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Hans J. Schlitt - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg
  • Stefan Fichtner-Feigl - Universitaetsklinik Regensburg, Klinik und Poliklinik fuer Chirurgie, Regensburg

Deutsche Gesellschaft für Chirurgie. 131. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 25.-28.03.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. Doc14dgch356

doi: 10.3205/14dgch356, urn:nbn:de:0183-14dgch3561

Veröffentlicht: 21. März 2014

© 2014 Brunner et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Introduction: Liver metastases occur in 40-50% of patients with colorectal cancer and determine longterm survival. The aim of this study was to examine the immunologic architecture of colorectal liver metastasis and its impact on patient survival.

Material and methods: 222 colorectal liver metastases were stained for H&E, masson trichrome, alpha smooth muscle actin, CD4, CD45RO and CD8. Besides histomorphologic evaluation, the immunohistochemical stainings were analysed for CD4+, CD45RO+ and CD8+ cell numbers separately for tumor, infiltrative margin and distant liver stroma. These findings were correlated with clinical data and patient outcome.

Results: Tumor containment by fibrotic capsule formation around the liver metastasis, observed in 38% of the patients, was a prognostic parameter for patient survival (P<0.0001) and independently lead to higher R0-resection rates (P=0.03). Dense infiltration of CD4+, CD45RO+ and CD8+ cells at the infiltrative margin correlated with increased patient survival (P=0.0002; P<0.0001; P=0.0098). In particular, localized cell infiltration at the infiltrative margin with low cell infiltration in the distant liver stroma, expressed by a ratio of CD4+, CD45RO+ and CD8+ cells >2, prolonged patient survival time (P<0.0001; P=0.0002; P<0.0001). Using these factors, a cellular immune score was designed that stratifies patient survival (P<0.0001).

Conclusion: Fibrotic capsule formation and localized cell infiltration of colorectal liver metastasis by CD4+, CD45RO+ and CD8+ cells prolong patient survival. Based on these immunologic criteria we developed a cellular immune score to stratify patients according to prognosis which potentially extends the immune scoring classification planned for primary colorectal carcinomas to patients with colorectal liver metastasis.