The fibrotic focus in advanced colorectal carcinoma: a hitherto unrecognized histological predictor for liver metastasis

A fibrotic focus (FF) is a clearly defined area consisting of fibroblasts a nd/or collagen fibres arranged in irregular or storiform patterns within tu mours. We looked to see whether FF in advanced colorectal carcinoma was ass ociated with distant organ metastasis especially to the liver. The correlat ion between FF and the presence of synchronous or total (synchronous and/or metachronous) liver metastasis and tumour recurrence was assessed in 77 pa tients with Dukes B and C advanced colorectal carcinoma treated by resectio n. The median follow-up period was 21 months. In multivariate analysis, FF significantly increased the relative risk (RR) of synchronous liver metasta sis (RR=4.9, P<0.05) and total liver metastasis (RR=4.6, P<0.05). FF also i ncreased the RR of tumour recurrence (RR=2.4), but the increase was not sta tistically significant. FF is a newly recognized histological indicator of liver metastasis in advanced colorectal carcinoma.