Prognostic assessment of histopathological growth patterns in colorectal liver metastasis: a literature review

Résumé

Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and the second leading cause of cancer-related mortality. Among patients undergoing surgical resection for colorectal liver metastases (CRLM), three main histopathological growth patterns (HGPs) are recognized: pushing, replacement, and desmoplastic (dHGP). These patterns reflect distinct modes of tumor–liver interaction, including differences in vascularization, stromal response, and the immune microenvironment. This study is a narrative review of the literature aiming to synthesize current knowledge on the distribution and prognostic significance of HGPs in CRLM. The available evidence suggests that the desmoplastic pattern is generally associated with more favorable outcomes compared to non-desmoplastic patterns. However, substantial heterogeneity exists across studies in terms of definitions, patient selection, treatment strategies, and outcome measures. In addition, no formal assessment of risk of bias was performed, which limits the strength of the conclusions. Although HGPs appear to be associated with clinical outcomes, their role in therapeutic decision-making remains uncertain. Current evidence does not support their routine use for guiding adjuvant or systemic treatment. Further prospective and standardized studies are required to clarify their clinical relevance and potential integration into multidisciplinary management strategies.

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