Fig. 6: Impact of neoadjuvant chemotherapy on growth pattern frequency.

a Change in percentages of encapsulated, pushing, and replacement patterns in patients who received chemotherapy vs. those who did not; Box-and-Whisker plot with median (line), interquartile range (box), minimum and maximum values within 1.5 times the IQR from the first and third quartiles (whiskers) and individual datapoints are shown. Result from two-sided Wilcoxon-test shown in the panel. b Distribution of the growth patterns per slide in chemonaive patients and patients who received neoadjuvant chemotherapy. Note the difference in encapsulation (blue). c, d Correlation between the percentages of encapsulated growth pattern and percentages of viable tumor cells in chemotherapy-treated (c) vs. untreated (d) patients. Individual datapoints and linear regression model (black line) with confidence intervals (in gray) are shown in (c) and (d). e Example of a treated metastasis (hematoxylin & eosin; representative of metastases from n = 165 patients), illustrating viable tumor cells remote from the surrounding liver parenchyma. The black circled structures denote necrotic tumor, the blue line the encapsulated, and the red line the replacement growth pattern. f Growth pattern frequencies of patients with stable disease or regression (orange) vs patients that progressed on neoadjuvant chemotherapy (blue); Box-and-Whisker plot, median (line), interquartile range (box), minimum and maximum values within 1.5 times the IQR from the first and third quartiles (whiskers) and individual datapoints are shown. Result from two-sided Wilcoxon-test shown in the panel. g Representative image (of n = 8 patients; hematoxylin & eosin) of a treated metastasis that progressed during chemotherapy, red line indicates (replacement-type) invasion front. Source data for the plots in (a), (c), (d), and (f) are provided with the Source Data file.