Metastatic patterns in adenocarcinoma

Hess, Kenneth R.; Varadhachary, Gauri R.; Taylor, Sarah H.; Wei, Wei; Raber, Martin N.; Lenzi, Renato; Abbruzzese, James L.

doi:10.1002/cncr.21778

Cited by 699 publications

(574 citation statements)

References 47 publications

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“…BM often are the sole site of failure in nonsmall cell lung cancer, whereas systemic disease usually precedes BM in CRC, because tumor cells generally must pass through both the liver and the lung before reaching the brain hematogenously. 10,31 Therefore, the presence of extracranial disease precludes patients from an RPA Class I classification.…”

Section: Discussionmentioning

confidence: 99%

Multidisciplinary management of colorectal brain metastases

Kruser

Chao

Elson

et al. 2008

Cancer

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BACKGROUND.The incidence of brain metastases (BM) from colorectal cancer (CRC) is increasing, and the management of this previously rare complication at a single institution is reported.METHODS.The records of all patients with BM from 1994 to 2005 were reviewed, and 49 patients (33 men, 16 women) with 102 BM from CRC were identified. Associations between patient and tumor characteristics, treatment modality, and survival were assessed.RESULTS.The median age at diagnosis of BM from CRC was 66 years. Forty patients (82%) had other systemic disease. The median survival after a diagnosis of BM from CRC was 5.1 months. Fifteen patients (31%) underwent surgery at some point, 14 patients (29%) underwent stereotactic radiosurgery (SRS), and 42 patients (86%) received whole‐brain radiotherapy during their management. Seven patients (14%) underwent upfront SRS. On multivariate analysis, a longer interval from diagnosis of CRC to diagnosis of BM was associated significantly with shorter survival (p = .01). Sex, Karnofsky performance status, tumor location, recursive partitioning analysis class, and initial treatment modality did not have an impact on survival.CONCLUSIONS.Because BM from CRC are a late‐stage phenomenon, the majority of patients in the current study had other systemic involvement, and survival after CNS involvement was poor. The results indicated that a high prevalence of systemic disease limits the proportion of patients who are strong candidates for upfront SRS, thereby limiting the impact that this modality has on outcomes in this population as a whole. Late development (>1 year after the primary tumor diagnosis) of CNS involvement may predict for poorer survival after therapy for patients with BM from CRC. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Multidisciplinary management of colorectal brain metastases

Kruser

Chao

Elson

et al. 2008

Cancer

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“…In one study involving 4399 patients, bone metastasis inflicts on 48% of breast cancer patients, 90% of prostate cancer patients, 39% of lung cancer patients and 35% of kidney cancer patients (Hess et al, 2006;Lu and Kang, 2007). It was estimated that 350 000 cancer patients die each year with bone metastasis (Mundy, 2002).…”

Section: Mechanisms Of Bone Homoeostasis and Metastasismentioning

confidence: 99%

Epidermal growth factor signalling and bone metastasis

Lü

Kang

2009

Br J Cancer

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Epidermal growth factor (EGF) signalling is well known for its multifaceted functions in development and tissue homoeostasis. The EGF family of ligands and receptors (ERBB family) have also been extensively investigated for their roles in promoting tumourigenesis and metastasis in a variety of cancer types. Recent findings indicate that EGF signalling is an important mediator of bone metastasis in breast, prostate and kidney cancers. The EGF signalling stimulates the growth of bone metastasis directly by increasing tumour cell proliferation and indirectly by engaging bone stromal cell in metastasis-promoting activities. Therefore, molecular targeting of ERBB receptors may benefit patients with bone metastasis and should be evaluated in clinical trials.

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“…The bone represents the most common site of metastasis in breast cancer patients (Mundy, 2002;Coleman, 2006;Hess et al, 2006). These skeletal metastases are typically characterized by excessive bone resorption (Kozlow and Guise, 2005).…”

Section: Introductionmentioning

confidence: 99%

Transforming growth factor-β1 is the predominant isoform required for breast cancer cell outgrowth in bone

Mourskaia

Dong

et al. 2008

Oncogene

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Transforming growth factor (TGF)-b signaling is a potent modulator of the invasive and metastatic behavior of breast cancer cells. Indeed, breast tumor responsiveness to TGF-b is important for the development of osteolytic bone metastases. However, the specific TGF-b isoforms that promote breast cancer outgrowth in bone is unknown. We demonstrate that expression of a TGF-b ligand trap, which neutralizes TGF-b1 and TGF-b3, in MDA-MB-231 breast cancer cells diminished their outgrowth in bone and reduced the severity of osteolytic lesion formation when compared with controls. We further show that a reduction or loss of TGF-b1 expression within the bone microenvironment of TGF-b1 þ /À and TGF-b1À/À mice significantly reduced the incidence of breast tumor outgrowth compared with wild-type animals. Interestingly, those tumors capable of growing within the tibiae of TGF-b1-deficient mice had upregulated expression of all three TGF-b isoforms. Finally, breast cancer cells expressing the TGF-b ligand trap showed a pronounced reduction in their ability to form osteolytic lesions when injected into the tibiae of TGF-b1 þ /À mice. Thus, our studies show that both host-and tumor-derived TGF-b expression plays a critical role during the establishment and outgrowth of breast cancer cells in bone.

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Metastatic patterns in adenocarcinoma

Abstract: The algorithms that the authors developed achieved a cross-validated accuracy of 64% and an accuracy of 64% on an 1851-patient independent test set, compared with 9% accuracy when a random classifier was used.

Cited by 699 publications

References 47 publications

Multidisciplinary management of colorectal brain metastases

Multidisciplinary management of colorectal brain metastases

Epidermal growth factor signalling and bone metastasis

Transforming growth factor-β1 is the predominant isoform required for breast cancer cell outgrowth in bone

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