Characterisation of clinico-pathological features and immune microenvironment of colorectal liver metastases

Surgical resection of colorectal liver metastases (CRLM) is the first choice of treatment when possible, aims to maximize patient survival and represents the only hope for a cure. In the last few years, the introduction of new molecules for neoadjuvant chemotherapy has made it possible to reduce tumour size to allow for a surgical resection, which may not otherwise have been feasible. Nonetheless, metastatic colorectal cancer continues to have a poor prognosis. In this thesis we undertook an in-depth analysis of the pathological characterization of CRLM to understand which parameters influence prognosis in a retrospective and in a prospective cohort of patients resected for CRLM. Then we explored the possible role of morphological heterogeneity of the pathological features regarding outcome. Our investigations demonstrated the clinical relevance of a complete pathological evaluation of all CRLM to stratify patient prognosis after surgery and attempted to provide another piece in the puzzle to understand tumoural heterogeneity and its possible influence on disease outcome.(MED - Sciences médicales) -- UCL, 202