Epidemiology and prognosis of synchronous and metachronous colon cancer metastases: A French population-based study

Ghiringhelli, François; Hennequin, Audrey; Drouillard, Antoine; Lepage, Côme; Faivre, Jean; Bouvier, Anne–Marie

doi:10.1016/j.dld.2014.05.011

Cited by 46 publications

(42 citation statements)

References 31 publications

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“…Survival differences were found for these two groups, with synchronous metastases considered to be of worse prognostic value compared to metachronous metastases [7]. Furthermore, the localization of metastases (e.g.…”

Section: Introductionmentioning

confidence: 94%

Pattern and Dynamics of Distant Metastases in Metastatic Colorectal Cancer

et al. 2017

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Background: Few studies report the incidence of metastatic patterns in colorectal cancer. Furthermore, little is known about dynamic aspects of these metastases during the course of disease. Methods: This retrospective cohort study involved 385 patients who received anti-tumor treatment at our institution (Department of Medical Oncology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Germany) for metastatic colorectal adenocarcinoma between 2007 and 2014. We reviewed all available imaging results of these patients to document the presence and detailed localization of metastases. Results: Most of the evaluated patients were initially diagnosed with metastases in the liver (70%), followed by the lungs (24%), distant lymph nodes (16%), and peritoneum (15%), besides rare anatomical sites (<5%). Colon and rectal cancer as well as synchronous and metachronous metastases differed with regard to the pattern of individual metastatic sites. The median time to first progressive disease (PD) with new metastases was 12.6 months. The time intervals between first and second as well as second and third PD with new metastases were comparable with 10.5 and 10.8 months, respectively. At initial diagnosis, the mean number of metastatic sites was 1.4 and increased to 2.6 at the third PD with new metastases. For patients with initially one metastatic site, the mean number increased to 2.2. Conclusion: The present analysis provides detailed information on the pattern and evolution of colorectal cancer metastases over time. Thus, it may establish the basis for prospective future research in this field.

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Section: Introductionmentioning

confidence: 94%

Pattern and Dynamics of Distant Metastases in Metastatic Colorectal Cancer

et al. 2017

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“…Synchronous and metachronous metastases contribute to the high mortality of CRC [2] and, despite improvements in the management of metastatic CRC, 5-year mortality remains up to 50% [1, 3, 4] with a worse outcome for synchronous versus metachronous metastasis (5-year relative survival 7.2% versus 17.6%) [2]. Discussion around the optimal management of synchronous metastasis from CRC is still open but it is reasonable to hypothesize that the difference in outcome between synchronous and metachronous metastases may not be entirely attributable to clinical variables.…”

Section: Introductionmentioning

confidence: 99%

Carbon dating cancer: defining the chronology of metastatic progression in colorectal cancer

et al. 2017

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BackgroundPatients often ask oncologists how long a cancer has been present before causing symptoms or spreading to other organs. The evolutionary trajectory of cancers can be defined using phylogenetic approaches but lack of chronological references makes dating the exact onset of tumours very challenging.Patients and methodsHere, we describe the case of a colorectal cancer (CRC) patient presenting with synchronous lung metastasis and metachronous thyroid, chest wall and urinary tract metastases over the course of 5 years. The chest wall metastasis was caused by needle tract seeding, implying a known time of onset. Using whole genome sequencing data from primary and metastatic sites we inferred the complete chronology of the cancer by exploiting the time of needle tract seeding as an in vivo ‘stopwatch’. This approach allowed us to follow the progression of the disease back in time, dating each ancestral node of the phylogenetic tree in the past history of the tumour. We used a Bayesian phylogenomic approach, which accounts for possible dynamic changes in mutational rate, to reconstruct the phylogenetic tree and effectively ‘carbon date’ the malignant progression.ResultsThe primary colon cancer emerged between 5 and 8 years before the clinical diagnosis. The primary tumour metastasized to the lung and the thyroid within a year from its onset. The thyroid lesion presented as a tumour-to-tumour deposit within a benign Hurthle adenoma. Despite rapid metastatic progression from the primary tumour, the patient showed an indolent disease course. Primary cancer and metastases were microsatellite stable and displayed low chromosomal instability. Neo-antigen analysis suggested minimal immunogenicity.ConclusionOur data provide the first in vivo experimental evidence documenting the timing of metastatic progression in CRC and suggest that genomic instability might be more important than the metastatic potential of the primary cancer in dictating CRC fate.

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“…Metachronous metastases can be defined as those diagnosed after the primary lesion in the colon and not simultaneously at the time of diagnosis of the primary tumor of the colon, which are defined as synchronous metastases [10]. With regard to location, about one-fifth of patients with CRC who present metachronous metastases shows peritoneal carcinomatosis.…”

Section: Extent Of Disease and Location Of Metastasesmentioning

confidence: 99%

Current controversies in the management of metastatic colorectal cancer

Vera

Alonso

Gállego

et al. 2015

Cancer Chemother Pharmacol

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The factors affecting the decisions for the treatment for patients with metastatic colorectal cancer (mCRC) are related to the patient, the tumor, and the treatment itself. Both cetuximab and panitumumab are anti-EGFR monoclonal antibody options for patients with RAS wild-type tumors. Several trials comparing these agents with bevacizumab are analyzed in this paper. The liver is the most common site of metastases in patients with CRC, and perioperative chemotherapy has been shown to yield benefits in this setting. In the second-line treatment for mCRC, maintenance with bevacizumab after progression following first-line treatment is convenient in some groups of patients with mCRC. Also, aflibercept has demonstrated benefits in response rate, progression-free survival, and overall survival in second-line treatment, whereas regorafenib provides benefits to patients progressing on all standard therapies. Several novel therapeutic options for patients with mCRC are under development, and these are discussed.

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Epidemiology and prognosis of synchronous and metachronous colon cancer metastases: A French population-based study

Cited by 46 publications

References 31 publications

Pattern and Dynamics of Distant Metastases in Metastatic Colorectal Cancer

Pattern and Dynamics of Distant Metastases in Metastatic Colorectal Cancer

Carbon dating cancer: defining the chronology of metastatic progression in colorectal cancer

Current controversies in the management of metastatic colorectal cancer

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