Oligometastatic Colorectal Cancer: A Review of Definitions and Patient Selection for Local Therapies

Miller, Eric D.; Hitchcock, Kathryn; Romesser, Paul B.

doi:10.1007/s12029-022-00900-5

Cited by 13 publications

(11 citation statements)

References 78 publications

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“…It has been known that OM has better outcomes than widespread metastases when treated aggressively [9][10][11]. Multidisciplinary care, including surgery, radiation, and systemic treatments, in the era of modern chemotherapy and immunotherapy has extended the life expectancy of these patients, especially with metastatic CRC [12,13]. Radiotherapy is no longer just a palliative treatment but also has survival benefits for selected stage IV CRC patients with OM [3,4,13].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that the use of radical treatments such as metastasectomy or SBRT can improve both LC and OS. They might also improve QoL by delaying systemic treatments that have severe toxicities [2,5,6,[13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Multidisciplinary care, including surgery, radiation, and systemic treatments, in the era of modern chemotherapy and immunotherapy has extended the life expectancy of these patients, especially with metastatic CRC [ 12 , 13 ]. Radiotherapy is no longer just a palliative treatment but also has survival benefits for selected stage IV CRC patients with OM [ 3 , 4 , 13 ]. Several studies have shown that the use of radical treatments such as metastasectomy or SBRT can improve both LC and OS.…”

Section: Discussionmentioning

confidence: 99%

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Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Pan

2024

Cureus

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We report a rare case of an extremely old colorectal cancer (CRC) patient who had complete remission after liver metastasectomy and stereotactic body radiotherapy (SBRT) to lung oligometastases (OM), with good quality of life and no evidence of recurrence 12 years after the initial diagnosis. An 83-year-old male patient had a right hemicolectomy for stage pT3 pN0 adenocarcinoma of the colon. Soon he was found to have liver metastasis treated with radiofrequency ablation and then liver metastasectomy with clear margins, followed by chemotherapy in the form of FOLFIRI for six months. Six years later, positron emission tomography (PET) showed 1.6 cm OM in the left upper lobe lung. He was not considered a good candidate for surgery. We offered him SBRT 48 Gy in four fractions every other day. The lesion disappeared with no recurrence in the same location on PET and serial computed tomography (CT) scans. Three years later, PET-CT found a new OM in the left lingular lung measuring 1.2 cm. A CT-guided lung biopsy confirmed invasive adenocarcinoma favoring OM from the CRC. SBRT planning failed due to its proximity to the heart. He accepted the longer course of conventional volumetric modulated arc therapy at 60 Gy in 15 fractions with daily cone-beam CT guidance. Again, he tolerated treatment very well with no significant side effects, despite his age. He did not require any chemotherapy or other systemic treatment in the last 11 years, so he did not experience any toxicities related to such treatment. This case is important to show that old age alone should not be considered a contraindication for metastasectomy and SBRT for CRC with liver and lung OM.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Pan

2024

Cureus

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“…Within colorectal cancer, oligo-metastatic disease confined to liver and/or lung is well studied [ 6 ]. Optimal management usually includes multi-disciplinary discussion of local therapy options, with consideration of patient and tumour factors [ 11 ]. For extra-hepato-pulmonary metastases the roles of resection, neoadjuvant and adjuvant chemotherapy is less clear.…”

Section: Discussionmentioning

confidence: 99%

Oligometastatic colorectal adenocarcinoma to the spleen and ovaries

Heath,

Novis,

Rabindran

et al. 2024

Journal of Surgical Case Reports

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In the context of colorectal cancer, splenic and ovarian metastases are rare outside of widely disseminated disease. Growing evidence suggests that ‘oligometastatic’ or limited metastatic disease can be treated surgically with good oncological outcomes. Splenic and ovarian metastases are not well represented in studies of oligometastatic colorectal cancer, resulting in uncertainty in the best management for these patients. We present the case of a 78-year-old woman diagnosed with oligometastatic colorectal cancer to bilateral ovaries and spleen, 5 years after resection of a primary colon cancer. The patient was treated with a bilateral salpingo-oopherectomy and subsequent open splenectomy. We discuss the role of surgery and peri-operative chemotherapy in the management of oligometastatic colorectal cancer involving atypical sites.

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“…According to statistics, there are more than 1.8 million new cases in the world every year ( 3 ). At present, due to the great progress in the pathophysiology of colorectal cancer, the treatment options have also increased, including endoscopic and surgical resection, radiotherapy, immunotherapy, targeted therapy, and local ablation ( 4 – 7 ). However, CRC is still the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide due to imperfect screening programs, treatment strategies, and increased incidence ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of SLC4A4 and its correlation with the microsatellite instability in colorectal cancer

et al. 2023

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ObjectiveTo explore new biomarkers related to microsatellite instability in order to better predict prognosis and guide medication.MethodsThe “limma” R package was used to identify differentially expressed genes in GSE24514, and then weighted correlation network analysis was used to select key genes. Different cell types in the tumor microenvironment were identified and analyzed by single-cell sequencing, with a Lasso regression model used to screen prognostic variables. Furthermore, the correlation between microsatellite instability and potential prognostic variables was explored, as well as the expression characteristics and clinical characteristics of the prognostic variables in the TCGA, UALCAN, and HPA databases. PCR assay was used to investigate the expression of SLC4A4 in colorectal cancer cell lines. Finally, we further verified the expression of SLC4A4 by immunohistochemistry.ResultsFirst, 844 differentially expressed genes in GSE24514 were identified. Subsequently, weighted co-expression network analysis (WGCNA) of GSE24514 obtained all the genes significantly associated with microsatellite instability (MSI), a total of 1452. Analysis of GSE166555 single cell sequencing data set yielded 1564 differentially expressed genes. The gene sets obtained from the above three analysis processes were intersected, and 174 genes were finally obtained. The Lasso regression model revealed two potential prognostic genes, TIMP1 and SLC4A4, of which, there was a stronger correlation between microsatellite instability and SLC4A4. The mRNA and protein expression of SLC4A4 was significantly decreased in tumors, and patients with low SLC4A4 expression had a poor prognosis. In addition, SLC4A4 was specifically expressed in epithelial cells. In the microenvironment of colorectal cancer, malignant cells have a strong interaction with different stromal cells. PCR showed that SLC4A4 was significantly down-regulated in colorectal cancer cell lines Caco-2, HCT116 and HT29 compared with normal control NCM460 cell lines. Immunohistochemistry also showed low expression of SLC4A4 in colorectal cancer.ConclusionSLC4A4, as a tumor suppressor gene, is significantly downregulated and positively correlated with microsatellite instability, thus it may be combined with microsatellite instability to guide colorectal cancer treatment.

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Oligometastatic Colorectal Cancer: A Review of Definitions and Patient Selection for Local Therapies

Cited by 13 publications

References 78 publications

Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Metastasectomy and Stereotactic Body Radiotherapy for Colorectal Cancer With Liver and Lung Oligometastases: A Case Report of Complete Remission in a 96-Year-Old Patient

Oligometastatic colorectal adenocarcinoma to the spleen and ovaries

Prognostic value of SLC4A4 and its correlation with the microsatellite instability in colorectal cancer

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