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Objectives: The multicenter study aimed to explore the relationship between the growth pattern of liver metastases on preoperative MRI and early recurrence in patients with colorectal cancer liver metastases (CRCLM) after surgery.Methods: A total of 348 CRCLM patients from 3 independent centers were enrolled, including 130 patients with 339 liver metastases in the primary cohort and 218 patients in validation cohorts. Referring to the gross classification of hepatocellular carcinoma (HCC), the growth pattern of each liver metastasis on MRI was classified into four types: rough, smooth, focal extranodular protuberant (FEP), and nodular confluent (NC). Disease-free survival (DFS) curve was constructed using the Kaplan-Meier method.Results: In primary cohort, 42 (12.4%) of the 339 liver metastases were rough type, 237 (69.9%) were smooth type, 29 (8.6%) were FEP type, and 31 (9.1%) were NC type. Those patients with FEP- and/or NC-type liver metastases had shorter DFS than those without such metastases (p < 0.05). However, there were no significant differences in DFS between patients with rough- and smooth-type liver metastases and those without such metastases. The patients with FEP- and/or NC-type liver metastases also had shorter DFS than those without such metastases in two external validation cohorts. In addition, 40.5% of high-risk-type (FEP and NC) liver metastases converted to low-risk types (rough and smooth) after neoadjuvant chemotherapy.Conclusion: The FEP- and NC-type liver metastases were associated with early recurrence, which may facilitate the clinical treatment of CRCLM patients.Key Points: • In the primary cohort, patients with FEP- and NC-type metastases had shorter disease-free survival (DFS) and a higher intrahepatic recurrence rate than patients without such metastases in the liver. • In the primary cohort, there were no significant differences in DFS or intrahepatic recurrence rate between patients with rough- and smooth-type metastases and those without such metastases in the liver. • High-risk patients had shorter DFS and a higher intrahepatic recurrence rate than low-risk patients in primary and external validation cohorts. [ABSTRACT FROM AUTHOR]

To investigate the impact of preoperative objective nutritional indices on the prognosis of patients with hepatocellular carcinoma (HCC) who underwent radical hepatectomy and to compare their predictive value for prognosis. The clinical data of 661 patients were retrospectively reviewed to analyze the risk factors associated with prognosis; explore the role of the prognostic nutritional index (PNI), nutritional risk index (NRI), and control nutritional status (CONUT) in HCC prognosis; and compare their predictive value. Several independent risk factors for overall survival (OS) were identified, including neutrophil count, prealbumin level, microvascular invasion (MVI), Barcelona Clinic Liver Cancer (BCLC) stage, and PNI. The following factors were confirmed to be associated with recurrence-free survival (RFS): alpha-fetoprotein (AFP) level, prothrombin time (PT), tumor size, tumor capsule, MVI, BCLC stage, and PNI. Compared with the corresponding subgroups, patients in the high PNI (>45) group and the high NRI (>100) group had better RFS and OS (P < 0.05). However, patients in the low CONUT score (≤3) group had a similar prognosis to patients in the high CONUT (>3) group (P = 0.050). Receiver operating characteristic (ROC) curve results showed that the area under the curve (AUC) of the PNI was significantly higher than that of the CONUT for RFS or OS but similar to that of the NRI. The predictive ability of the PNI for HCC prognosis was significantly better than that of the CONUT but similar to that of the NRI. [ABSTRACT FROM AUTHOR]