Hematogenous Metastatic Patterns of Curatively Resected Colon Cancer Were Different from Those of Stage IV and Autopsy Cases

Sadahiro, Sotaro; Suzuki, Toshiyuki; Okada, Kazutake; Kamata, Hiroko

doi:10.1093/jjco/hyt002

Cited by 14 publications

(14 citation statements)

References 11 publications

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“…The only group where liver metastases were clearly more common was in stage IV patients with single metastases. Similar findings were reported in a recent Japanese hospital study 28 , where lung metastases were more frequent in CRC patients who underwent curative surgery, compared with stage IV patients. Therefore, it seems that lung metastases need a longer time to grow, compared with liver metastases.…”

Section: Discussionsupporting

confidence: 90%

Patterns of metastasis in colon and rectal cancer

Riihimäki

Hemminki

Sundquist

et al. 2016

Sci Rep

717

530

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Investigating epidemiology of metastatic colon and rectal cancer is challenging, because cancer registries seldom record metastatic sites. We used a population based approach to assess metastatic spread in colon and rectal cancers. 49,096 patients with colorectal cancer were identified from the nationwide Swedish Cancer Registry. Metastatic sites were identified from the National Patient Register and Cause of Death Register. Rectal cancer more frequently metastasized into thoracic organs (OR = 2.4) and the nervous system (1.5) and less frequently within the peritoneum (0.3). Mucinous and signet ring adenocarcinomas more frequently metastasized within the peritoneum compared with generic adenocarcinoma (3.8 [colon]/3.2 [rectum]), and less frequently into the liver (0.5/0.6). Lung metastases occurred frequently together with nervous system metastases, whereas peritoneal metastases were often listed with ovarian and pleural metastases. Thoracic metastases are almost as common as liver metastases in rectal cancer patients with a low stage at diagnosis. In colorectal cancer patients with solitary metastases the survival differed between 5 and 19 months depending on T or N stage. Metastatic patterns differ notably between colon and rectal cancers. This knowledge should help clinicians to identify patients in need for extra surveillance and gives insight to further studies on the mechanisms of metastasis.

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Section: Discussionsupporting

confidence: 90%

Patterns of metastasis in colon and rectal cancer

Riihimäki

Hemminki

Sundquist

et al. 2016

Sci Rep

717

530

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“…Improvement in OS and DFS using the XELOX regimen on stage III colon cancer was also supported by another study observing a 5-year OS of 77.6% and a 3-year DFS of 70.9% (5). Furthermore, locoregional spread was the common recurrence pattern in the local patients, which is contrary with previous reports showing the liver as the common site of metastasis due to its location and vascularization (29,30). Dissimilarity of our results with others might be explained by clinical practice in our local setting that showed a general lack of lymph nodes removal.…”

Section: Discussionmentioning

confidence: 69%

Effects of oxaliplatin-containing adjuvant chemotherapy on short-term survival of patients with colon cancer in Dr. Sardjito Hospital, Yogyakarta, Indonesia

Wardhani

Hutajulu

Ferianti

et al. 2019

J. Gastrointest. Oncol

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Background: Oxaliplatin-based adjuvant chemotherapy has been applied as standard treatment for high risk stages II and III colon cancer in many countries. There was no comprehensive report of oxaliplatin use in Indonesia. This research aimed to evaluate the short-term survival of patients with colon cancer treated with such strategy and the prognostic factors. Methods: Medical records of patients with colon cancer receiving oxaliplatin-containing adjuvant chemotherapy were retrospectively reviewed. Demography, clinicopathological, and treatment data were collected. Two-year overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier method and survival predictors were estimated using Cox proportional hazard models. Results: Data of 81 patients had been included with a median follow-up of 25.2 months. The estimated OS and DFS at 2 years were 75.8% and 72.7%. In multivariate analyses, the Eastern Cooperative Oncology Group (ECOG) 2 performance status [hazard ratio (HR) =2.967; 95% confidence interval (CI), 1.265 to 6.957; P=0.012], T4 stage (HR =2.669; 95% CI, 1.087 to 6.557; P=0.032), and less cycles of chemotherapy administration (HR =3.280; 95% CI, 1.333 to 8.070; P=0.010) were significant independent factors for an increased risk of death. Cases with moderately to poorly differentiated tumors had significantly worse DFS compared with those with well differentiated tumors (HR =3.503; 95% CI, 1.403 to 8.744; P=0.007). Conclusions: Colon cancer patients receiving oxaliplatin-based adjuvant regimens in our clinical practice had 2-year OS rate of 75.8% and 2-year DFS rate of 72.7%. ECOG 2 performance status, T4 stage, and less cycles of chemotherapy administration significantly predicted a poor OS and moderately to poorly histological grade significantly predicted a poor DFS.

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“…11 Aggressive local hematogenous spread (84%) is much more common than distant metastasis (19%). 12,13 When distant metastasis does occur, it is often diagnosed several years after the initial time of treatment for the primary tumor. 14 In our case, the patient was lost to follow-up for three years before returning for evaluation of hematochezia.…”

Section: Discussionmentioning

confidence: 99%

Primary Colon Adenocarcinoma with Metastatic Disease to the Rectum Followed by the Left Axilla

Lucke‐Wold

Bonasso

Cassim

2017

AMSRJ

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Introduction Adenocarcinoma of the colon can metastasize to multiple organs but very rarely metastasizes to the axilla. Case We present a case of a 56-year-old male with metastatic colon adenocarcinoma that metastasized to the rectum and then the axilla. Three years after initial diagnosis and treatment of right colon mucinous adenocarcinoma a metastatic mass was found in the rectum. The mass was successfully resected, but within a year of finding the rectal mass, metastatic disease to the axilla was discovered. Conclusion This case provides valuable teaching points about routes of metastasis and the importance of continued clinical follow-up in patients diagnosed with adenocarcinoma of the colon.

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Hematogenous Metastatic Patterns of Curatively Resected Colon Cancer Were Different from Those of Stage IV and Autopsy Cases

Cited by 14 publications

References 11 publications

Patterns of metastasis in colon and rectal cancer

Patterns of metastasis in colon and rectal cancer

Effects of oxaliplatin-containing adjuvant chemotherapy on short-term survival of patients with colon cancer in Dr. Sardjito Hospital, Yogyakarta, Indonesia

Primary Colon Adenocarcinoma with Metastatic Disease to the Rectum Followed by the Left Axilla

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