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Background <p>Colorectal cancer liver metastases (CRLMs) are a frequent pattern of recurrence, yet the prognostic impact of background liver fibrosis remains unclear. This study aimed to quantitatively assess hepatic fibrosis histologically and determine its association with intrahepatic recurrence after resection.</p> Methods <p>Patients who underwent hepatic resection for CRLM between 1999 and 2022 were retrospectively included in this study. Background liver fibrosis was evaluated histologically and quantified via whole-slide imaging. Fibrosis was analyzed as a continuous variable using Cox proportional hazards modeling. Additionally, patients were stratified into two groups (fibrosis vs non-fibrosis) using a cutoff determined by receive operating characteristic (ROC) analysis.</p> Results <p>Among 102 patients, 24 (23.5%) were classified into the fibrosis group. Intrahepatic recurrence after hepatic surgery occurred for 36.3% of all the patients, with a significantly higher rate in the fibrosis group than in the non-fibrosis group (58.3% vs 29.5%; <i>p</i> = 0.019), whereas no significant differences were observed in extrahepatic recurrence between the groups (41.7% vs 43.6%; <i>p</i> = 1.0). In the multivariable analysis, fibrotic area percentage was independently associated with intrahepatic recurrence (hazard ratio, 1.45; 95% confidence interval, 1.06–1.98; <i>p</i> = 0.02), demonstrating a linear relationship between fibrosis extent and recurrence risk.</p> Conclusion <p>Histopathologically quantified background liver fibrosis is an independent risk factor for intrahepatic recurrence after CRLM resection. These findings underscore the potential role of the liver microenvironment in tumor recurrence and support further studies exploring hepatic fibrosis as a biomarker for postoperative risk stratification.</p>

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Background Liver Fibrosis as a Microenvironmental Risk Factor for Intrahepatic Recurrence in Colorectal Liver Metastases

  • 期刊论文

  • 发表日期：

    2026年1月27日

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  • Satoru Morita,
  • Koji Okabayashi,
  • Yutaka Endo,
  • Yutaka Kurebayashi,
  • Yohei Masugi,
  • Tokiya Abe,
  • Yasushi Hasegawa,
  • Yuta Abe,
  • Minoru Kitago,
  • Ryo Seishima,
  • Kohei Shigeta,
  • Yuko Kitagawa

摘要

Background

Colorectal cancer liver metastases (CRLMs) are a frequent pattern of recurrence, yet the prognostic impact of background liver fibrosis remains unclear. This study aimed to quantitatively assess hepatic fibrosis histologically and determine its association with intrahepatic recurrence after resection.

Methods

Patients who underwent hepatic resection for CRLM between 1999 and 2022 were retrospectively included in this study. Background liver fibrosis was evaluated histologically and quantified via whole-slide imaging. Fibrosis was analyzed as a continuous variable using Cox proportional hazards modeling. Additionally, patients were stratified into two groups (fibrosis vs non-fibrosis) using a cutoff determined by receive operating characteristic (ROC) analysis.

Results

Among 102 patients, 24 (23.5%) were classified into the fibrosis group. Intrahepatic recurrence after hepatic surgery occurred for 36.3% of all the patients, with a significantly higher rate in the fibrosis group than in the non-fibrosis group (58.3% vs 29.5%; p = 0.019), whereas no significant differences were observed in extrahepatic recurrence between the groups (41.7% vs 43.6%; p = 1.0). In the multivariable analysis, fibrotic area percentage was independently associated with intrahepatic recurrence (hazard ratio, 1.45; 95% confidence interval, 1.06–1.98; p = 0.02), demonstrating a linear relationship between fibrosis extent and recurrence risk.

Conclusion

Histopathologically quantified background liver fibrosis is an independent risk factor for intrahepatic recurrence after CRLM resection. These findings underscore the potential role of the liver microenvironment in tumor recurrence and support further studies exploring hepatic fibrosis as a biomarker for postoperative risk stratification.