Stage IV colorectal cancer primary site and patterns of distant metastasis

Abstract

Background Although colorectal cancer (CRC) usually metastasizes to the liver and/or lungs, factors influencing the anatomic pattern of metastases remain poorly understood. Methods We assessed the relationship between primary CRC site and pattern of synchronous metastasis among 1,202 individuals diagnosed with incident metastatic CRC between 2010–2014 and identified through the Seattle-Puget Sound Surveillance, Epidemiology, and End Results (SEER) registry. Polytomous logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between primary tumor site and synchronous metastatic pattern. Results Compared to patients with proximal colon primaries, patients with rectal primaries were more likely to present with lungs-only or liver and lungs metastases versus liver-only metastases (ORlungs–only vs. liver-only: 2.39, 95% CI: 1.35–4.24, ORliver+lungs vs. liver-only: 2.20, 95% CI: 1.46–3.32). Conclusion These findings suggest that patients with rectal primaries are more likely than patients with colon primaries to present with synchronous lung metastases.

The Impact of Primary Tumor Location in Synchronous Metastatic Colorectal Cancer: Differences in Metastatic Sites and Survival

“…These findings are consistent with previous epidemiologic research that indicates a relationship between primary tumor location and metastatic location. [17][18][19] The results presented in the current paper add valuable information, because previous publications are limited by their relatively small sample size, grouping together of metachronous and synchronous metastases, or the absence of several sites of metastasis. 19 The differences in metastatic sites can be explained by several hypotheses.…”

“…[17][18][19] The results presented in the current paper add valuable information, because previous publications are limited by their relatively small sample size, grouping together of metachronous and synchronous metastases, or the absence of several sites of metastasis. 19 The differences in metastatic sites can be explained by several hypotheses. 17,18,20 First, there is the seed-and-soil hypothesis, which states that tumor metastases have a preference for specific organs (e.g., the liver), based on interactions between tumor cells and their microenvironment.…”

“…This is most evident for the increased numbers of lung metastases derived from the rectum, because venous drainage of the rectum bypasses the portal system and encounters the central circulation first. 2,18,19 The differences in metastatic sites could be partly responsible for differences in survival between primary tumor locations. Peritoneal metastases, which are associated with poor survival, were more commonly found for RCC.…”

ZEB2-AS1 Accelerates Epithelial/Mesenchymal Transition Through miR-1205/CRKL Pathway in Colorectal Cancer

“…5,6 The most common reason of low survival rate is the frequency of recurrence and distant metastasis in advanced stage of CRC. 7 Unfortunately, until now, the underlying mechanisms of malignant growth and metastatic behaviors of CRC cells are not fully understood.…”

Validation of computational methods for fracture assessment of metastatic disease to the proximal femur

“…Lesion formation is heavily influenced by location of the primary tumor. Breast cancers are more likely to metastasize to the spine, lung cancers are more likely to metastasize to the ribs, colon cancers are more likely to metastasize to the liver and lungs, and prostate cancers are more likely to metastasize to the pelvis [5,6]. Metastasis to bone is the third most common site behind the lungs and liver, and metastatic tumors are far more common than primary bone cancers [7][8][9].…”