Haematogenous metastastic patterns in colonic carcinoma: An analysis of 1541 necropsies

Abstract

The sequence of events in haematogenous metastasis from colonic carcinoma was analysed, using 1541 necropsy reports from 16 centres. The findings are consistent with the cascade hypothesis that metastases develop in discrete steps, first in the liver, next in the lungs and finally, in other sites. Deviations of necropsy findings from the cascade model are largely explained on the basis of false negative reports. In only 216 of 1194 cases was there suggestive evidence that metastatic patterns (excluding lymph nodes) were causally related to lymphatic or non-haematogenous pathways. The incidence of metastatic involvement in 'other' (quaternary) sites correlated with target organ blood-flow (ml min-) per g, only when bone marrow and thyroid were excluded. In the thyroid the incidence was lower than expected on the basis of blood flow per g tissue; this may indicate that the thyroid is an unfavourable site for metastatic growth of colonic carcinoma. In the bone marrow it is higher; the latter may be due to delivery of cancer cells via both arterial blood and the vertebral venous plexus. Recognition of this pattern of metastases in the bone marrow could be important with respect of diagnosis and therapy, in patients with colonic carcinoma.

microRNA-320a inhibits tumor invasion by targeting neuropilin�1 and is associated with liver metastasis in colorectal cancer

“…To evaluate the effect of miR320a on cellular proliferation, 2x10 3 LoVo cells infected with pGIF-320a and/or control vector were seeded into 96-well plates in complete medium. After 2 days, the cell viability was measured by MTT assay using the Cell Proliferation Kit I according to the manufacturer's instructions (Roche).…”

“…Of all patients who die of advanced colorectal cancer (ACRC), 60-70% display liver metastasis (2). Metastasis to the liver is the major cause of death in CRC patients (3). The formation of liver metastases is a multistep process involving the escape of tumor cells from a primary CRC, intravasation into the systemic circulation, survival during transit in the vasculature, extravasation into the parenchyma of liver tissues, and ultimately the outgrowth of macroscopic liver metastasis formation through proliferation and angiogenesis (4)(5)(6).…”

The exon‐level biomarker SLC39A14 has organ‐confined cancer‐specificity in colorectal cancer

“…The liver is often the first site of distant metastasis from CRC. 15 Early detection of metastatic lesions may influence the treatment strategy and improve the patient's prognosis. 16 Currently, detection is mainly based on imaging techniques.…”

Surgical resection of hepatic metastases from colorectal cancer: A systematic review of published studies

“…Surgery is the treatment of choice for patients with localised disease but over half of all patients will develop metastases. The liver is often the first site of metastatic disease and may be the only site of spread in as many as 30 -40% of patients with advanced disease (Weiss et al, 1986; Hugh et al, 1997a).It has been postulated that because haematogenous spread usually occurs in a stepwise fashion, initially to the liver, with subsequent intrahepatic spread via the portal vein and further spread to the systemic circulation, surgical resection of isolated hepatic metastases from colorectal cancer may be curative.The natural history of metastatic colorectal cancer is variable, with a median survival without treatment of only 8 months (Seymour et al, 1997;Simmonds, 2000). Patients with isolated hepatic metastases have a better prognosis than those with more extensive metastatic disease (Goslin et al, 1982; Lahr et al, 1983;Stangl et al, 1994;Rougier et al, 1995) suggesting biological differences in the two settings (Goslin et al, 1982; Lahr et al, 1983;Stangl et al, 1994;Rougier et al, 1995).…”

“…Surgery is the treatment of choice for patients with localised disease but over half of all patients will develop metastases. The liver is often the first site of metastatic disease and may be the only site of spread in as many as 30 -40% of patients with advanced disease (Weiss et al, 1986; Hugh et al, 1997a).…”