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1

Al-Muqbel, Kusai M. "Bone Marrow Metastasis Is an Early Stage of Bone Metastasis in Breast Cancer Detected Clinically by F18-FDG-PET/CT Imaging." BioMed Research International 2017 (2017): 1–7. http://dx.doi.org/10.1155/2017/9852632.

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Objective. To determine the value of 18F-FDG PET/CT in detection of bone marrow (BM) metastasis in breast cancer which is considered an early stage of bone metastasis. Patients and Methods. Retrospectively, breast cancer patients with bone metastasis were included. BM metastasis was considered if the lesion was PET positive/CT occult while bone metastasis was considered if the lesion was PET positive/ CT positive. BM metastases were observed sequentially on F18-FDG PET/CT. Results. We included 35 patients. Eighteen patients (51%) had BM metastases in addition to other bone metastases. BM metastases comprised 24% of all lesions. Posttreatment scan was performed on 26/35 patients. Twenty-three percent of BM metastases had resolved completely without causing bone destruction after treatment. Sixty-five percent of BM metastases had converted into bone metastases after treatment. Twelve percent of BM metastases had persisted after treatment. Conclusion. This retrospective study showed clinically by 18F-FDG PET/CT imaging that BM metastasis is an early stage of bone metastasis in breast cancer. Interestingly, 18F-FDG-PET/CT showed that early eradication of individual BM metastasis by systemic treatment precluded development of bone metastasis. However, more research is needed to study the impact of an early diagnosis of BM metastases on treatment outcome.
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2

Fidler, Isaiah J. "Melanoma Metastasis." Cancer Control 2, no. 5 (September 1995): 398–404. http://dx.doi.org/10.1177/107327489500200503.

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Cancer metastasis requires a series of sequential steps, each of which is rate limiting. Neoplasms are biologically heterogeneous, and the process of metastasis is highly selective. Multiple metastases often differ in biologic characteristics and can change during the course of the disease. Clonal analysis of human melanoma suggest that systemic, physiologic signals can be recognized by neoplastic cells. Brain metastases are particularly common in patients with metastatic melanoma. The blood brain barrier does not prevent the invasion of the brain parenchyma by circulating metastatic cells, and its permeability varies among different experimental brain metastases.
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3

Ali, Kamran, Sukki Cho, Hyo Jun Jang, Kwhanmien Kim, and Sanghoon Jheon. "Predictive Factors of Thoracic Lymph Node Metastasis Accompanying Pulmonary Metastasis from Colorectal Cancer." Thoracic and Cardiovascular Surgeon 67, no. 08 (May 29, 2018): 683–87. http://dx.doi.org/10.1055/s-0038-1642602.

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Background The aim of this study was to identify the factors predicting thoracic lymph node (LN) metastases for pulmonary resection from colorectal cancer (CRC). Methods The records of 160 patients who underwent pulmonary metastasectomy for CRC were retrospectively reviewed. Clinicopathologic factors were analyzed with chi-square test or t-test and logistic regression to identify predictable factors for LN metastases. Results Sixty patients (37.5%) underwent LN dissection during pulmonary metastasectomy, and LN metastases were found in five patients. Twenty-three patients had LN recurrence among the 100 patients (62.5%) without LN dissection during the follow-up period. Twenty-eight patients out of 160 (17.5%) had LN metastases. By multivariate analysis, the number of pulmonary metastasis and metastasis from colon cancers were independent factors predicting LN metastases. Conclusion The number of pulmonary metastasis and metastasis from colon cancers were independent factors predicting LN metastases. LN sampling should be performed especially in cases with strong predictive factors to improve staging and help guide further treatment.
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4

Qin, Lang, Xiangtian Yu, Chuang Xu, and Yangchen Liu. "Prognostic impact of metastatic patterns and treatment modalities on overall survival in lung squamous cell carcinoma: A population-based study." Medicine 102, no. 29 (July 21, 2023): e34251. http://dx.doi.org/10.1097/md.0000000000034251.

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This study aimed to investigate the impact of distinct metastasis patterns on the overall survival (OS) of individuals diagnosed with organ metastatic lung squamous cell carcinoma (LUSC). OS was calculated using the Kaplan–Meier method, and univariate and multivariate Cox regression analyses were conducted to further assess prognostic factors. A total of 36,025 cases meeting the specified criteria were extracted from the Surveillance, Epidemiology, and End Results database. Among these patients, 30.60% (11,023/36,025) were initially diagnosed at stage IV, and 22.03% (7936/36,025) of these individuals exhibited metastasis in at least 1 organ, including the liver, bone, lung, and brain. Among the 4 types of single metastasis, patients with bone metastasis had the lowest mean OS, at 9.438 months (95% CI: 8.684–10.192). Furthermore, among patients with dual-organ metastases, those with both brain and liver metastases had the shortest mean OS, at 5.523 months (95% CI: 3.762–7.285). Multivariate Cox regression analysis revealed that metastatic site is an independent prognostic factor for OS in patients with single and dual-organ metastases. Chemotherapy was beneficial for patients with single and multiple-organ metastases; although surgery was advantageous for those with single and dual-organ metastases, it did not affect the long-term prognosis of patients with triple organ metastases. Radiotherapy only conferred benefits to patients with single-organ metastasis. LUSC patients exhibit a high incidence of metastasis at the time of initial diagnosis, with significant differences in long-term survival among patients with different patterns of metastasis. Among single-organ metastasis cases, lung metastasis is the most frequent and is associated with the longest mean OS. Regarding treatment options, patients with single-organ metastasis can benefit from chemotherapy, surgery, and radiotherapy, and those with metastasis in 2 organs can benefit from chemotherapy and surgery. Patients with metastasis in more than 2 organs, however, can only benefit from chemotherapy. Understanding the variations in metastasis patterns assists in guiding pretreatment assessments and in determining appropriate therapeutic interventions for LUSC.
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5

Pisani, P., G. Angeli, M. Krengli, and F. Pia. "Renal carcinoma metastasis to the parotid gland." Journal of Laryngology & Otology 104, no. 4 (April 1990): 352–54. http://dx.doi.org/10.1017/s0022215100112691.

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AbstractMetastatic tumours in major salivary glands are uncommon with a higher incidence of primary sites from the head and neck. The lungs and breast are the common primary sites, while metastases from the kidney are very rarely found. The authors describe a case of renal clear-cell carcinoma with metastastis to the parotid gland. The incidence of a metastasis in the parotid gland from a primary renal carcinoma, even if rare, should not be overlooked in making a correct differential diagnosis with acinic cell carcinoma and monomorphic clear cell adenoma.
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6

Isidro, Ulysses, Liam M. O'Brien, and Ronnie Sebro. "Linear mixed-effects models for estimation of pulmonary metastasis growth rate: implications for CT surveillance in patients with sarcoma." British Journal of Radiology 93, no. 1114 (October 1, 2020): 20190856. http://dx.doi.org/10.1259/bjr.20190856.

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Objectives: Sarcoma patients often undergo surveillance chest CT for detection of pulmonary metastases. No data exist on the optimal surveillance interval for chest CT. The aim of this study was to estimate pulmonary metastasis growth rate in sarcoma patients. Methods: This was a retrospective review of 95 patients with pulmonary metastases (43 patients with histologically confirmed metastases and 52 with clinically diagnosed metastases) from sarcoma treated at an academic tertiary-care center between 01 January 2000 and 01 June 2019. Age, sex, primary tumor size, grade, subtype, size and volume of the pulmonary metastasis over successive chest CT scans were recorded. Two metastases per patient were chosen if possible. Multivariate linear mixed-effects models with random effects for each pulmonary metastasis and each patient were used to estimate pulmonary metastasis growth rate, evaluating the impact of patient age, tumor size, tumor grade, chemotherapy and tumor subtype. We estimated the pulmonary metastasis volume doubling time using these analyses. Results: Maximal primary tumor size at diagnosis (LRT statistic = 2.58, df = 2, p = 0.275), tumor grade (LRT statistic = 1.13, df = 2, p = 0.567), tumor type (LRT statistic = 7.59, df = 6, p = 0.269), and patient age at diagnosis (LRT statistic = 0.735, df = 2, p = 0.736) were not statistically significant predictors of pulmonary nodule growth from baseline values. Chemotherapy decreased the rate of pulmonary nodule growth from baseline (LRT statistic = 7.96, df = 2, p = 0.0187). 95% of untreated pulmonary metastases are expected to grow less than 6 mm in 6.4 months. There was significant intrapatient and interpatient variation in pulmonary metastasis growth rate. Pulmonary metastasis volume growth rate was best fit with an exponential model in time. The volume doubling time for pulmonary metastases assuming an exponential model in time was 143 days (95% CI (104, 231) days). Conclusions: Assuming a 2 mm nodule is the smallest reliably detectable nodule by CT, the data suggest that an untreated pulmonary metastasis is expected to grow to 8 mm in 8.4 months (95% CI (4.9, 10.2) months). Tumor size, grade and sarcoma subtype did not significantly alter pulmonary metastasis growth rate. However, chemotherapy slowed the pulmonary metastasis growth rate. Advances in knowledge: CT surveillance intervals for pulmonary metastases can be estimated based on metastasis growth rate. There was significant variation in the pulmonary metastasis growth rate between metastases within patient and between patients. Pulmonary nodule volume growth followed an exponential model, linear in time.
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7

Choi, Hee Jun, Jai Min Ryu, Byung Joo Chae, Seok Jin Nam, Jonghan Yu, Se Kyung Lee, Jeong Eon Lee, and Seok Won Kim. "Is Sentinel Lymph Node Biopsy for Breast Cancer with Cytology-Proven Axillary Metastasis Safe? A Prospective Single-Arm Study." Journal of Clinical Medicine 10, no. 20 (October 16, 2021): 4754. http://dx.doi.org/10.3390/jcm10204754.

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The purpose of this study was to evaluate pathologic lymph node metastasis in breast cancer with cytology-proven axillary metastasis. This study was designed prospectively. We performed axillary lymph node dissections (ALND) after lymphatic mapping by near-infrared (NIR) fluorescence imaging with Indocyanine Green (ICG). We evaluated 72 breast cancer patients with cytology-proven axillary metastasis by curative surgery at the Samsung Medical Center between May of 2016 and December of 2017. Among the 72 patients with cytology-proven axillary metastasis, 14 of 39 patients (35.9%) with one or two sentinel lymph nodes containing metastases were metastasized to post-sentinel lymph node. Thirteen of fourteen patients had additional non-sentinel lymph node metastases, seven of thirteen patients also had additional level II lymph node metastases, and one patient had only one additional level II lymph node metastasis. Of T1 or T2 stage patients, 10 of 33 patients (30.3%) with one or two sentinel lymph nodes containing metastases were metastasized to post-sentinel lymph node. Even in patients without SLN metastasis, 50% of the patients had at least three LN metastases, and 40% in the T1 or T2 stage patients. Sentinel lymph node biopsy without ALND might be not safe for patients with cytology-proven axillary metastasis.
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8

Park, Hyung Kyu, Joungho Han, Ghee Young Kwon, Min-Kyung Yeo, and Go Eun Bae. "Patterns of Extrathoracic Metastasis in Lung Cancer Patients." Current Oncology 29, no. 11 (November 16, 2022): 8794–801. http://dx.doi.org/10.3390/curroncol29110691.

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Metastasis is a major cause of death in lung cancer patients. Therefore, a deeper understanding of the metastatic mechanisms is important for developing better management strategies for lung cancer patients. This study evaluated the patterns of extrathoracic metastases in lung cancer. We retrieved data for 25,103 lung cancer patients from an institutional database and then evaluated the impacts of clinicopathologic factors on metastasis patterns. We found that 36.5% of patients had extrathoracic metastasis. Younger patients had a significantly higher extrathoracic metastasis rate in most histologic subtypes. Metastases to the bone (58.3%), central nervous system (CNS) (44.3%), liver (26.6%) and adrenal gland (18.3%) accounted for 85.5% of all extrathoracic metastases. Patients with nonmucinous adenocarcinoma had significantly higher bone metastasis rate. Patients with small cell carcinoma and large cell neuroendocrine carcinoma (LCNEC) had significantly higher liver metastasis rates. Further, patients with LCNEC also had a significantly lower bone metastasis rate, and patients with squamous cell carcinoma had a significantly lower CNS metastasis rate. Patients with multiple cancers had similar patterns of metastasis compared to patients with only lung cancer. In conclusion, different histologic subtypes of lung cancer have different metastatic patterns. Our study might help clinicians decide on follow-up strategies.
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9

Li, Chuang, Zhao-zhong Meng, Jian-wu Qin, and Xin-guang Qiu. "Analysis of Risk Factors of Level V Lymphatic Metastasis for Papillary Thyroid Carcinoma with pN1b." Journal of Oncology 2021 (August 18, 2021): 1–5. http://dx.doi.org/10.1155/2021/5562065.

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Objective. To explore the risk factors of level V lymphatic metastasis in papillary thyroid carcinoma (PTC) patients with pN1b. Methods. Patients were selected if they presented with a suspicious level III or IV lymph node metastasis and underwent surgery by hemi or total thyroidectomy with a lymph node dissection (levels III, IV, VI, and VII). For these patients, if frozen section showed a positive level III or IV node, then levels II and V nodes were resected. Univariate analysis was performed using the chi-square test for some factors, including age, sex, tumor location, multifocal lesions, tumor size, local invasion of primary focus, status of cervical lymphatic metastasis, TNM staging, tumor deposits (independent tumor nodules), and the metastasis to more than 5 central lymph nodes. Then, the factors with statistical significance indicated by the above univariate analysis underwent multivariate analysis. Results. Univariate analysis indicated that the level V lymphatic metastasis was significantly associated with simultaneous metastases to levels II, III, and IV, simultaneous metastases to levels III and IV, and tumor deposits (all p < 0.05 ), but it was not significantly associated with age, sex, tumor location, multifocal lesions, tumor size, local invasion of primary focus, other cervical lymphatic metastasis, TNM staging, and the metastases to more than 5 central lymph nodes (all p > 0.05 ). Multivariate analysis suggested that the simultaneous metastases to levels III and IV and tumor deposits were the risk factors of level V lymphatic metastasis. Conclusion. The simultaneous metastases to levels III and IV and tumor deposits are independent risk factors of level V lymphatic metastasis. The patients with pN1b PTC who have simultaneous metastases to levels III and IV or/and tumor deposits may have the risk of level V lymph node metastasis.
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10

Suki, Dima, Rami Khoury Abdulla, Minming Ding, Soumen Khatua, and Raymond Sawaya. "Brain metastases in patients diagnosed with a solid primary cancer during childhood: experience from a single referral cancer center." Journal of Neurosurgery: Pediatrics 14, no. 4 (October 2014): 372–85. http://dx.doi.org/10.3171/2014.7.peds13318.

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Object Metastasis to the brain is frequent in adult cancer patients but rare among children. Advances in primary tumor treatment and the associated prolonged survival are said to have increased the frequency of brain metastasis in children. The authors present a series of cases of brain metastases in children diagnosed with a solid primary cancer, evaluate brain metastasis trends, and describe tumor type, patterns of occurrence, and prognosis. Methods Patients with brain metastases whose primary cancer was diagnosed during childhood were identified in the 1990–2012 Tumor Registry at The University of Texas M.D. Anderson Cancer Center. A review of their hospital records provided demographic data, history, and clinical data, including primary cancer sites, number and location of brain metastases, sites of extracranial metastases, treatments, and outcomes. Results Fifty-four pediatric patients (1.4%) had a brain metastasis from a solid primary tumor. Sarcomas were the most common (54%), followed by melanoma (15%). The patients' median ages at diagnosis of the primary cancer and the brain metastasis were 11.37 years and 15.03 years, respectively. The primary cancer was localized at diagnosis in 48% of patients and disseminated regionally in only 14%. The primary tumor and brain metastasis presented synchronously in 15% of patients, and other extracranial metastases were present when the primary cancer was diagnosed. The remaining patients were diagnosed with brain metastasis after initiation of primary cancer treatment, with a median presentation interval of 17 months after primary cancer diagnosis (range 2–77 months). At the time of diagnosis, the brain metastasis was the first site of systemic metastasis in only 4 (8%) of the 51 patients for whom data were available. Up to 70% of patients had lung metastases when brain metastases were found. Symptoms led to the brain metastasis diagnosis in 65% of cases. Brain metastases were single in 60% of cases and multiple in 35%; 6% had only leptomeningeal disease. The median Kaplan-Meier estimates of survival after diagnoses of primary cancer and brain metastasis were 29 months (95% CI 24–34 months) and 9 months (95% CI 6–11 months), respectively. Untreated patients survived for a median of 0.9 months after brain metastasis diagnosis (95% CI 0.3–1.5 months). Those receiving treatment survived for a median of 8 months after initiation of therapy (95% CI 6–11 months). Conclusions The results of this study challenge the current notion of an increased incidence of brain metastases among children with a solid primary cancer. The earlier diagnosis of the primary cancer, prior to its dissemination to distant sites (especially the brain), and initiation of presumably more effective treatments may support such an observation. However, although the actual number of cases may not be increasing, the prognosis after the diagnosis of a brain metastasis remains poor regardless of the management strategy.
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11

Costa, Weruska Alcoforado, José Eleutério Jr., Paulo César Giraldo, and Ana Katherine Gonçalves. "Quality of life in breast cancer survivors." Revista da Associação Médica Brasileira 63, no. 7 (July 2017): 583–89. http://dx.doi.org/10.1590/1806-9282.63.07.583.

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Summary Objective: To evaluate the influence of functional capacity (FC) and how it affects quality of life (QoL) in breast cancer survivors. Method: A total of 400 breast cancer survivors were studied - 118 without metastasis, 160 with locoregional metastasis and 122 with distant metastasis. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire--Core 30 (EORTC QLQ-C30), Breast Cancer-Specific (EORTC QLQ-BR23), and the Karnofsky Performance Scale (KPS) were used to evaluate FC and QoL. Results: Women with distant metastases presented lower KPS 75.3 (SD=12.5) (p<0.001). For QLQ-C30, the mean of the Functional Scale for patients with distant metastasis was 57 (SD=19) (p<0.001), and the mean of the Symptom Scale for patients with distant metastasis was 37 (SD=20) (p<0.001). Both the scales for pain and fatigue showed the highest mean in the groups. For the Global Health Scale, patients without metastasis scored a mean of 62 (SD=24) points, while those with locoregional metastases scored a mean of 63 (SD=21.4), and distant metastasis scored 51.3 (SD=24) points. In the group with distant metastases, 105 (87%) had pain, and the average KPS was 74 (SD=12.0) (p=0.001). Conclusion: Breast cancer was associated with decreased FC, compromised QoL in women with locoregional and distant metastases compared to those without metastasis.
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Zhang, Lei, Chengyu Wu, Yong Zhang, and Robert M. Hoffman. "Spontaneous and cyclophosphamide-enhanced metastasis inhibited by traditional Chinese medicine (TCM) herbal mixture LQ." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): e22209-e22209. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e22209.

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e22209 Background: Cyclophosphamide pretreatment of mice enhances metastatsis of HT1080 human fibrosarsoma cells (Cancer Res. 68, 516-520, 2008). Methods: HT1080 human fibrosarsoma cells were injected into the footpad or were injected into the epigastric cranialis vein of mice pre-treated with cyclophosphamide (CYC) or a combination of CYC and the herbal mixture LQ. The efficacy was monitored through dynamic subcellular imaging of trafficking of cancer cells in lymph nodes and blood vessels in live mice. Results: LQ significantly inhibited HT1080 spontaneous metastases to local lymph nodes in the foot-pad-injection model. In the control group, 100% of mice had lymph node metastasis, compared to 12.5% of the mice in the LQ treatment group. LQ also significantly inhibited CYC-enhanced experimental metastasis in the epigastric cranialis vein injection model. LQ prolonged the overall survival of mice in the spontaneous-lymph-node metastatic footpad-injection model. Conclusions: The TCM herbal mixture LQ shows promis to inhibit metastasis and will be further tested in other metastatic models.
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13

Wang, Yuezhu, Margaret R. Smith, Yin Liu, Mary E. Green, Omer A. Hassan, Alexandra M. Balmaceda, Tammy Sexton, Wencheng Li, and Fei Xing. "Abstract 3782: IASLC grading system predict distant metastases for resected lung adenocarcinoma." Cancer Research 84, no. 6_Supplement (March 22, 2024): 3782. http://dx.doi.org/10.1158/1538-7445.am2024-3782.

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Abstract The International Association for the Study of Lung Cancer (IASLC) proposed a new histological grading system for invasive lung adenocarcinoma (LUAD). However, whether this new grading system is able to predict distant metastases in LUAD patients has not been evaluated. This study investigated the feasibility of using this grading system to predict the occurrence of brain and bone metastases in patients with resectable LUAD which identifies patients who have a high probability of developing distant metastases after surgery. We collected clinical information and pathological reports of 179 early stage LUAD patients who underwent resection during 2008 to 2015 from Wake Forest Comprehensive Cancer Center. All patients were followed up for 5 years and both bone and brain metastasis-free survival were calculated. Tumor grading of all samples was evaluated by both IASLC grading and predominant pattern-based grading systems. The ability of predicting distant metastases using IASLC grading and tumor stage were examined by receiver operating characteristic curves (ROC). 28 out of 179 patients developed distant metastases in five years with a median overall survival of 60 months for metastasis-free patients and 38.9 for patients with distant metastasis. Compared to predominant pattern-based grading system, IASLC grading system showed a stronger correlation with distant metastasis incidence. Complex gland pattern is enriched in patients who developed bone and brain metastases compared to metastasis-free patients. IASLC grading system also showed a superior prediction power of distant metastasis compared to tumor stage with area under curve (AUC) of 0.69 for brain metastasis and 0.71 for bone metastasis. IASLC grading system is capable of predicting the incidence of distant metastasis among early-stage invasive LUAD patients. Citation Format: Yuezhu Wang, Margaret R. Smith, Yin Liu, Mary E. Green, Omer A. Hassan, Alexandra M. Balmaceda, Tammy Sexton, Wencheng Li, Fei Xing. IASLC grading system predict distant metastases for resected lung adenocarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3782.
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Vasilev, Nikolay, Vladimir Perelmuter, Yevgeniy Choynzonov, Irina Frolova, Stanislav Tabakaev, Yuriy Tyukalov, Marat Mukhamedov, et al. "ANALYSIS OF CASES WITH LYMPHOGENOUS METASTASIS FROM CHONDROSARCOMA." Problems in oncology 65, no. 5 (May 1, 2019): 736–43. http://dx.doi.org/10.37469/0507-3758-2019-65-5-736-743.

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Between 2008 and 2017, 87 patients with lymphogenous metastasis from chondrosarcoma were treated at the Cancer Research Institute (Tomsk, Russia). Lymph node metastases were detected in 3 patients (3.4 %). All cases with lymphogenous metastases were characterized by the presence of the tumor in the appendicular skeleton, tumor extension beyond the bone with the formation of extraossal component, high-grade tumor (G2 and G3) and disease progression. Our study indicates the importance of the study of lymphogenous metastasis as evidence of an unfavorable outcome for chondrosarcoma. Further studies of risk factors for lymphogenous metastases and the mechanisms underlying lymphogenous metastasis will allow a better understanding of the phenomenon of lymphogenous metastasis.
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Asano, Naofumi, Michiro Susa, Seiichi Hosaka, Robert Nakayama, Eisuke Kobayashi, Katsuhito Takeuchi, Keisuke Horiuchi, et al. "Metastatic Patterns of Myxoid/Round Cell Liposarcoma: A Review of a 25-Year Experience." Sarcoma 2012 (2012): 1–6. http://dx.doi.org/10.1155/2012/345161.

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Myxoid/round cell liposarcoma (MRCL), unlike other soft tissue sarcomas, has been associated with unusual pattern of metastasis to extrapulmonary sites. In an attempt to elucidate the clinical features of MRCL with metastatic lesions, 58 cases, from the medical database of Keio University Hospital were used for the evaluation. 47 patients (81%) had no metastases, whereas 11 patients (11%) had metastases during their clinical course. Among the 11 patients with metastatic lesions, 8 patients (73%) had extrapulmonary metastases and 3 patients (27%) had pulmonary metastases. Patients were further divided into three groups; without metastasis, with extrapulmonary metastasis, and with pulmonary metastasis. When the metastatic patterns were stratified according to tumor size, there was statistical significance between the three groups (P=0.028). The 8 cases with extrapulmonary metastases were all larger than 10 cm. Similarly, histological grading had a significant impact on metastatic patterns (P=0.027). 3 cases with pulmonary metastatic lesions were all diagnosed as high grade. In conclusion, large size and low histological grade were significantly associated with extrapulmonary metastasis.
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Begum, Shamim MF, Fatima Begum, Pupree Mutsuddy, Layla S. Banu, and Raihan Hussain. "Superficial Metastases from Breast Cancer and Gallbladder: Detected by 18F FDG PET-CT Scan." Bangladesh Journal of Nuclear Medicine 20, no. 1 (June 7, 2018): 56. http://dx.doi.org/10.3329/bjnm.v20i1.36862.

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<p>Cutaneous and subcutaneous metastases from internal malignancies are rare. The reported incidence of subcutaneous metastasis is 5.3% and cutaneous metastasis account for 0.7% and 9% of all metastases. Here we reported two cases of cutaneous metastasis, one from gall bladder cancer and other from breast cancer. Among all internal malignancies the incidence of cutaneous metastasis in breast cancer is highest whereas in gall bladder cancer is rare. Detection of cutaneous or subcutaneous metastasis determines the staging, prognosis and management strategy of the disease. 18F FDG PET- CT (18 Fluorine fluorodeoxyglucose positron emission tomography computerized tomography) scan has been reported to play a potential role in the identification of cutaneous or subcutaneas metastasis. These metastases were detected on whole body 18F FDG PET-CT scan during restaging of the disease. The lesions were FDG avid and biopsy proven metastasis. Intense FDG avidity with SUV max 10.5 was revealed in nodular lesion in abdominal wall from gall bladder cancer. The nodular lesion in gluteal region in a patient with breast cancer had low avidity with SUV max 3.8 later evaluated as cutaneous metastasis. Here the cases are reported to emphasize the PET-CT imaging as a potentially used one-stop-shop imaging modality in patients with cutaneous or subcutaneous metastases from internal malignancies. PET-CT imaging can reliably identify hypermetabolic cutaneous metastasis and can help not only to restage the disease but also to guide new therapeutic strategies.</p><p>Bangladesh J. Nuclear Med. 20(1): 56-58, January 2017</p>
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Chan, Chung Ming, Adam D. Lindsay, Andre RV Spiguel, Mark T. Scarborough, and C. Parker Gibbs. "Brain metastases from Truncal and extremity bone and soft tissue sarcoma: Single institution study of oncologic outcomes." Rare Tumors 12 (January 2020): 203636132096006. http://dx.doi.org/10.1177/2036361320960060.

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Brain metastases are a rare occurrence in patients with sarcoma. The prognosis for patients is poor, and treatment can contribute to considerable morbidity. We sought to examine the experience of our institution in managing these patients over a period of 17 years. We performed a retrospective cohort study of patients managed for sarcoma of the extremity or trunk who developed brain metastases from 2000 to 2017. Clinical data were analyzed and we assessed survival outcomes. 14 patients presenting at a mean age of 46.7 years were included. All patients were treated with radiotherapy for their brain metastases. 3 patients underwent surgical excision of their intracranial metastases. Two patients were treated with radium-223 dichloride. Kaplan–Meier survival analysis and the log rank test were used to calculate the survival probability, and to compare patient subgroups. All patients in this study developed lung or bone metastases at a mean interval of 13.3 months prior to the development of brain metastasis. The median interval from diagnosis of a brain metastasis to death was 3.6 months. The Kaplan–Meier survival probability at 6 months was 28.6%, and 14.3% at 1 year. Surgery was not found to be associated with increased survival. Patients with cerebellar metastasis had increased survival probability as compared to those with cerebral metastasis. Patients with extremity or trunk sarcoma who develop brain metastases frequently develop lung or bone metastases in the year preceding their diagnosis of brain metastasis. Patients with cerebellar metastasis may have better survival than those with cerebral metastasis, and an aggressive treatment approach should be considered. Despite aggressive treatment, the prognosis is grim.
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Özer, Özge, Emirhan Nemutlu, Cemil Can Eylem, Sedef Kır, Tuba Reçber, Burak Yasin Aktas, Ayse Kars, and Sercan Aksoy. "Detection of brain metastasis by metabolomics methods in metastatic breast cancer patients." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e12572-e12572. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12572.

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e12572 Background: The aim of this study was to identify markers for the early diagnosis of brain metastasis by metabolomic methods in breast cancer patients. Methods: A total of 88 breast cancer patients with distant metastases were included the study. The patients were divided into two groups according to their metastasis status as patients with brain metastases and patients with distant metastases without any brain metastases. For metabolomic analyses, liquid chromatography quadrupole time-of-flight mass spectrometry (LC-qTOF-MS) and gas chromatography mass spectrometry (GC-MS) analysis methods were used. Results: 88 patients were included the study. 33 of the 88 patients had brain metastasis group and 55 patients had distant metastases without brain metastasis. A total of 79 metabolites were identified by the GC-MS analysis. Of these, 11 of them (alanine, sphingosine, fructose, fumaric acid, glycine, lactic acid, phenylalanine, pyroglutamic acid, serine, threonine, and valine) were found at statistically significantly higher levels in the patient group with brain metastases (p < 0.05). In LC-qTOF-MS analysis 47 metabolites were identified with statistically significant results between the two groups. Predictive accuriecies for idendification of the brain metastasis with 5 and 10 metobolites models were 94.6% and 95.2%, respectively.Amino acyl tRNA biosynthesis, arginine and proline metabolism, nitrogen metabolism, cyanaminoacid metabolism, nicontic and nicotinicamide metabolism, glycine, serine and threonine metabolism pathways have been involved more significantly in patients with brain metastasis (p < 0.05). Conclusions: Although these results need to be confirmatory prospective studies, these data promising for early detection of the brain metastasis by markers in sera.
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Gill, Jennifer G., Samantha N. Leef, Vijayashree Ramesh, Misty S. Martin-Sandoval, Aparna D. Rao, Lindsey West, Sarah Muh, et al. "A Short Isoform of Spermatogenic Enzyme GAPDHS Functions as a Metabolic Switch and Limits Metastasis in Melanoma." Cancer Research 82, no. 7 (February 11, 2022): 1251–66. http://dx.doi.org/10.1158/0008-5472.can-21-2062.

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Abstract Despite being the leading cause of cancer deaths, metastasis remains a poorly understood process. To identify novel regulators of metastasis in melanoma, we performed a large-scale RNA sequencing screen of 48 samples from patient-derived xenograft (PDX) subcutaneous melanomas and their associated metastases. In comparison with primary tumors, expression of glycolytic genes was frequently decreased in metastases, whereas expression of some tricarboxylic acid (TCA) cycle genes was increased in metastases. Consistent with these transcriptional changes, melanoma metastases underwent a metabolic switch characterized by decreased levels of glycolytic metabolites and increased abundance of TCA cycle metabolites. A short isoform of glyceraldehyde-3-phosphate dehydrogenase, spermatogenic (GAPDHS) lacking the N-terminal domain suppressed metastasis and regulated this metabolic switch. GAPDHS was downregulated in metastatic nodules from PDX models as well as in human patients. Overexpression of GAPDHS was sufficient to block melanoma metastasis, whereas its inhibition promoted metastasis, decreased glycolysis, and increased levels of certain TCA cycle metabolites and their derivatives including citrate, fumarate, malate, and aspartate. Isotope tracing studies indicated that GAPDHS mediates this shift through changes in pyruvate carboxylase activity and aspartate synthesis, both metabolic pathways critical for cancer survival and metastasis. Together, these data identify a short isoform of GAPDHS that limits melanoma metastasis and regulates central carbon metabolism. Significance: This study characterizes metabolic changes during cancer metastasis and identifies GAPDHS as a novel regulator of these processes in melanoma cells.
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Muratori, Francesco, Leonardo Bettini, Filippo Frenos, Nicola Mondanelli, Daniela Greto, Lorenzo Livi, Alessandro Franchi, et al. "Myxoid Liposarcoma: Prognostic Factors and Metastatic Pattern in a Series of 148 Patients Treated at a Single Institution." International Journal of Surgical Oncology 2018 (May 16, 2018): 1–9. http://dx.doi.org/10.1155/2018/8928706.

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Objectives. The authors reported a retrospective study on myxoid liposarcomas (MLs), evaluating factors that may influence overall survival (OS), local recurrence-free survival (LRFS), metastasis-free survival (MFS), and analyzing the metastatic pattern. Methods. 148 MLs were analyzed. The sites of metastases were investigated. Results. Margins (p = 0.002), grading (p = 0,0479), and metastasis (p < 0,0001) were significant risk factors affecting overall survival (OS). Type of presentation (p = 0.0243), grading (p = 0,0055), margin (p = 0.0001), and local recurrence (0.0437) were risk factors on metastasis-free survival (MFS). Authors did not observe statistically significant risk factors for local recurrence-free survival (LRFS) and reported 55% extrapulmonary metastases and 45% pulmonary metastases. Conclusion. Margins, grading, presentation, local recurrence, and metastasis were prognostic factors. Extrapulmonary metastases were more frequent in myxoid liposarcoma.
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Sassu, Carolina Maria, Claudia Marchetti, Giorgia Russo, Angelo Minucci, Serena Maria Boccia, Alberto Benato, Camilla Nero, et al. "Epithelial ovarian cancer and brain metastases: might theBRCAstatus, PARP inhibitor administration, and surgical treatment impact the survival?" International Journal of Gynecologic Cancer 34, no. 1 (January 2024): 88–98. http://dx.doi.org/10.1136/ijgc-2023-004980.

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ObjectiveTo evaluate disease characteristics and survival according toBRCAstatus, administration of poly-(ADP-ribose) polymerase inhibitors (PARPi), and surgery in patients with ovarian cancer and brain metastases.MethodsThis is a monocentric retrospective cohort of patients with ovarian cancer and brain metastases treated between 2000 and 2021. Data were collected by a retrospective review of medical records and analyzed according to: (1)BRCAmutation; (2) PARPi before and after brain metastases; (3) surgery for brain metastases.ResultsEighty-five patients with ovarian cancer and brain metastasis and knownBRCAstatus (31BRCAmutated (BRCAm), 54BRCAwild-type (BRCAwt)) were analyzed. Twenty-two patients had received PARPi before brain metastases diagnosis (11BRCAm, 11BRCAwt) and 12 after (8BRCAm, 4BRCAwt). Brain metastases occurred >1 year later in patients who had received previous PARPi. Survival was longer in theBRCAm group (median post-brain metastasis survival:BRCAm 23 months vsBRCAwt 8 months, p=0.0015). No differences were found based onBRCAstatus analyzing the population who did not receive PARPi after brain metastasis (median post-brain metastasis survival:BRCAm 8 months vsBRCAwt 8 months, p=0.31). In theBRCAm group, survival was worse in patients who had received previous PARPi (median post-brain metastasis survival: PARPi before, 7 months vs no-PARPi before, 24 months, p=0.003). If PARPi was administered after brain metastases, survival of the overall population improved (median post-brain metastasis survival: PARPi after, 46 months vs no-PARPi after, 8 months, p=0.00038).In cases of surgery for brain metastases, the prognosis seemed better (median post-brain metastasis survival: surgery 13 months vs no-surgery 8 months, p=0.036). Three variables were significantly associated with prolonged survival at multivariate analysis:BRCAmutation, multimodal treatment, and ≤1 previous chemotherapy line.ConclusionsBRCAmutations might impact brain metastasis occurrence and lead to better outcomes. In a multimodal treatment, surgery seems to affect survival even in cases of extracranial disease. PARPi use should be considered as it seems to prolong survival if administered after brain metastasis.
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Xiong, Min, Weiguang Zhang, Chao Zhou, Junjie Bao, Shengbing Zang, and Xiaoping Lin. "Application of 18F Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography in Monitoring Gastric Metastasis and Cancer Thrombi from Renal Cell Carcinoma." Journal of Oncology 2022 (February 4, 2022): 1–13. http://dx.doi.org/10.1155/2022/5681463.

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Background. Renal cell carcinoma (RCC) with gastric metastasis is rare, particularly accompanied by multiple cancer thrombi. Methods. We reported a 66-year-old man with a history of a right radical nephrectomy because of RCC. The patient underwent 18F prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) scanning after 6 months of targeted therapy because of gastric metastasis and cancer thrombi. We conducted a systematic review of the literature and identified 73 cases of RCC with gastric metastasis. We analyzed the clinicopathological characteristics, therapies, and outcomes of patients. Results. 18F-PSMA PET/CT showed a large mass in the gastric fundus and cancer thrombi in the right atrium, inferior vena cava, and splenic vein with intense tracer uptake. Other metastases with increased tracer uptake included multiple bones and abdominal lymph nodes. The majority of gastric metastasis of RCC were men (53/73, 72.6%), with a median age at presentation of 67 (from 48 to 87) years. Gastric metastasis of RCC was mainly metachronous, and presented with small polyps or mass appearance and often accompanied by multiple-site metastases and gastrointestinal symptoms. An overall median interval between nephrectomy and diagnosis of gastric metastasis was 6 (from 0.1 to 23) years, and an overall median survival time was 14 (from 0.25 to 72) months. The median interval time of solitary gastric metastasis was longer than gastric metastasis with multiple-site metastases (7 vs.5 years; P = 0.034 ). Patients with gastric and multiple-site metastases had higher mortality than patients with solitary metastasis (17 vs.1; P = 0.028 ). The patients with synchronous gastric metastasis had a shorter survival time than metachronous gastric metastasis (6 vs.17 months; P = 0.018 ). Conclusions. Postoperative follow-up of multiple imaging modalities to monitor recurrence and metastasis is necessary and important. PSMA PET/CT can improve the detection sensitivity of RCC, especially in metastatic clear cell renal cell carcinoma (ccRCC), and could provide a basis for disease staging, restaging, and therapeutic efficacy evaluation.
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Reticker-Flynn, Nathan E., Weiruo Zhang, Julia Ann Belk, Pamela Antonia Basto, Ansuman Satpathy, Sylvia Katina Plevritis, and Edgar G. Engleman. "Lymph node colonization promotes distant tumor metastasis through the induction of tumor-specific immune tolerance." Journal of Immunology 208, no. 1_Supplement (May 1, 2022): 119.04. http://dx.doi.org/10.4049/jimmunol.208.supp.119.04.

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Abstract The majority of cancer deaths result from distant organ metastasis. Lymph nodes (LNs) are major sites of anti-tumor lymphocyte education, yet LN metastasis frequently precedes distant metastasis. Here, we find that LN metastasis represents a critical step in tumor progression by inducing tumor-specific immune tolerance, thus enabling further dissemination of tumors to distant organs. Using an in vivo passaging approach, we generated 300 cell lines exhibiting varying degrees of LN metastatic capacity. We show that the LN metastases promote distant organ metastasis in a manner that is tumor specific. Through organism-wide immune profiling by single cell sequencing, we identify multiple cellular mediators of tolerance. In particular, we find that LN metastases have the capacity to both resist NK cell cytotoxicity and induce regulatory T cells (Tregs). Adoptive transfer of Tregs from the LNs of mice bearing LN metastasis to naïve mice facilitates metastasis in a manner that Tregs from mice without LN metastases cannot. Additionally, these Tregs are induced in an antigen-specific manner. Using whole exome sequencing, we show LN metastases do not evolve through the acquisition of driver mutations, loss of neoantigens, loss of MHC class I, or decreases in melanoma antigens. Rather, by RNA-seq and ATAC-seq, we show that a conserved interferon signaling axis is upregulated in LN metastases and is rendered stable through epigenetic regulation of chromatin accessibility. Knockout studies reveal that these pathways are required for LN metastatic seeding, and we validate their significance in additional mouse models and patients. These findings demonstrate a critical role for LN metastasis in promoting tumor-specific immunosuppression. This work was supported by NIH grants U54 CA209971 and F32 CA189408.
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Grigoryeva, Evgeniya S., Luibov A. Tashireva, Olga E. Savelieva, Marina V. Zavyalova, Nataliya O. Popova, Gleb A. Kuznetsov, Elena S. Andryuhova, and Vladimir M. Perelmuter. "The Association of Integrins β3, β4, and αVβ5 on Exosomes, CTCs and Tumor Cells with Localization of Distant Metastasis in Breast Cancer Patients." International Journal of Molecular Sciences 24, no. 3 (February 2, 2023): 2929. http://dx.doi.org/10.3390/ijms24032929.

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Integrins are cell adhesion receptors, which play a role in breast cancer invasion, angiogenesis, and metastasis. Moreover, it has been shown that exosomal integrins provide organotropic metastasis in a mouse model. In our study, we aimed to investigate the expression of integrins β3, β4, and αVβ5 on exosomes and tumor cells (circulating tumor cells and primary tumor) and their association with the localization of distant metastasis. We confirmed the association of exosomal integrin β4 with lung metastasis in breast cancer patients. However, we were unable to evaluate the role of integrin β3 in brain metastasis due to the rarity of this localization. We established no association of exosomal integrin αVβ5 with liver metastasis in our cohort of breast cancer patients. The further evaluation of β3, β4, and αVβ5 integrin expression on CTCs revealed an association of integrin β4 and αVβ5 with liver, but not the lung metastases. Integrin β4 in the primary tumor was associated with liver metastasis. Furthermore, an in-depth analysis of phenotypic characteristics of β4+ tumor cells revealed a significantly increased proportion of E-cadherin+ and CD44+CD24- cells in patients with liver metastases compared to patients with lung or no distant metastases.
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Chao, Z., X. Guo, Y. Xu, X. Han, X. Wang, and G. Wang. "The Homogeneous and Heterogeneous Risk Factors for the Morbidity and Prognosis of Bone Metastasis in Patients With Prostate Cancer." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 51s. http://dx.doi.org/10.1200/jgo.18.38300.

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Background: Globally, prostate cancer is the second most common malignancy in males and fifth leading cancer-related cause of death. To build a reliable predictive system for screening performance, the study looking into the risk factors of BM in prostate cancer patients is warranted. Aim: Using the Surveillance, Epidemiology, and End Results database (SEER) to assess the incidence, and risk factors of morbidity and prognosis for bone metastases in initial metastatic prostate cancer. Methods: A total of 249,331 prostate cancer patients who were diagnosed between 2010 and 2014 in SEER database were obtained to investigate the risk factors for developing bone metastasis, and 9925 of them who registered before 2013 were retrieved (with at least 1 year follow-up) to explore the prognostic factors for bone metastasis. Multivariate logistic and Cox regression were used to identify risk factors and prognostic factors for bone metastases, respectively. Results: Totally, 12,794 patients (5.1%) were diagnosed with bone metastases at the initial diagnosis. Older age, unmarried status, higher tumor stage, lymph node metastasis, metastases at lung brain and liver were the homogeneous risk factors for the morbidity and prognosis of bone metastasis in prostate cancer. Race and histologic differentiation grade were the heterogeneities associated factors. Black race was positively associated with bone metastasis morbidity; however, it has no significant effect on the prognosis. Poor differentiated grade may be the risk factors for developing bone metastasis; however, grade II was negatively associated with prognosis of bone metastasis. Conclusion: The survival of prostate cancer was poor with the bone metastasis approximate 5%. The prostate cancer has homogeneous and heterogeneities risk factors for incidence and prognosis of bone metastasis, which may provide potential guideline for the screening and preventive treatment of the bone metastasis of prostate cancer.
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Guo, Jianbin, Xiujuan Cui, Xindong Zhang, Haili Qian, Hua Duan, and Ying Zhang. "The Clinical Characteristics of Endometrial Cancer With Extraperitoneal Metastasis and the Value of Surgery in Treatment." Technology in Cancer Research & Treatment 19 (January 1, 2020): 153303382094578. http://dx.doi.org/10.1177/1533033820945784.

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Objective: To describe the clinical and pathological features of endometrial carcinoma with extraperitoneal metastasis and examine whether surgery could improve the prognosis. Methods: The Surveillance, Epidemiology, and End Results database was used to analyze 730 patients who were diagnosed with extraperitoneal metastasis of endometrial cancer from 2010 to 2015, including metastasis to the lung, bone, or brain. Results: Of the 730 patients, 372 (50.96%) patients had single lung metastases, and 196(26.85%) patients had multiple organ metastases that included pulmonary invasion. Therefore, the lung was the most common target organ for extraperitoneal metastasis of endometrial cancer. In multivariate risk factor analysis, grade 3 tumor (odds ratio = 3.39, P < .001), positive peritoneal cytology (odds ratio = 2.02, P < .001), and cervical stromal invasion (odds ratio = 1.42, P = .030) were independent risk factors for extraperitoneal metastasis. Once metastasis occurred in the brain or multiple organs, the prognosis was often poor. Of the patients, 362 underwent surgery, and surgery was performed only for primary tumors of the reproductive organs in almost all patients (97.23%) with extraperitoneal metastasis. The median cancer-specific survival periods of patients with solitary pulmonary metastasis undergoing surgery and those without surgery were 23 (16.43-29.57) months and 9 (6.21-11.79) months, respectively ( P < .001), and survival superiority also existed in patients with bone metastasis (19 vs 8 months, P = .015) and multiple organs metastases (15 vs 4 months, P < .001). However, patients with brain metastasis had the same median survival period in the 2 groups (6 months, P = .146). Conclusions: The lung was the most common target organ for extraperitoneal metastasis in patients with endometrial cancer. Surgery was associated with improved survival in women with extraperitoneal metastasis, except for patients with brain metastasis.
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Langley, Robert R., and Isaiah J. Fidler. "The Biology of Brain Metastasis." Clinical Chemistry 59, no. 1 (January 1, 2013): 180–89. http://dx.doi.org/10.1373/clinchem.2012.193342.

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BACKGROUND It is estimated that at least 200 000 cases of brain metastases occur each year in the US, which is 10 times the number of patients diagnosed with primary brain tumors. Brain metastasis is associated with poor prognosis, neurological deterioration, diminished quality of life, and extremely short survival. Favorable interactions between tumor cells and cerebral microvascular endothelial cells encourage tumor growth in the central nervous system, while tumor cell interactions with astrocytes protect brain metastases from the cytotoxic effects of chemotherapy. CONTENT We review the pathogenesis of brain metastasis and emphasize the contributions of microvascular endothelial cells and astrocytes to disease progression and therapeutic resistance. Animal models used to study brain metastasis are also discussed. SUMMARY Brain metastasis has many unmet clinical needs. There are few clinically relevant tumor models and no targeted therapies specific for brain metastases, and the mean survival for untreated patients is 5 weeks. Improved clinical outcomes are dependent on an enhanced understanding of the metastasis-initiating population of cells and the identification of microenvironmental factors that encourage disease progression in the central nervous system.
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Su, ChunXia, Juan Zhou, Xiangling Chu, and Jing Zhao. "Genetic mutations associated with lung cancer metastasis to the brain." Journal of Global Oncology 5, suppl (October 7, 2019): 41. http://dx.doi.org/10.1200/jgo.2019.5.suppl.41.

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41 Background: Lung cancer is the most common cause of mortality in both men and women, accounting for one-quarter of all cancer deaths. Most lung cancer-associated deaths result from metastasis, especially brain metastasis. Metastasis associated mutations are important biomarkers for metastasis prediction and outcome improvement. The current study aimed to reveal the molecular mechanisms and the genetic alterations involved in metastasis from lung tumors to the brain. Methods: We carried out whole exome sequencing (WES) of the primary tumors and the corresponding brain metastases from 15 patients with metastatic non-small-cell lung carcinoma. Results: We identified novel lung cancer metastases associated genes (CHEK2P2, BAGE2, AHNAK2) and epigenetic factors (miR-4436A, miR-6077). Lung-brain metastasis samples have more similar Ti/Tv(transition/transversion) profile with brain cancer. Focal adhesion, PI3K-Akt signaling pathway, MAPK signaling pathway are some of the most important tumor onset and metastasis pathways. Alternative splicing, Methylation and EGF-like domain are important metabolic abnormal for the lung-metastasis cancers. Conclusions: We conducted a pairwise lung-brain metastasis based WES and identified some novel metastasis related mutations which provided potential biomarkers for prognosis and targeted therapeutics.
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Ikram, Chamtouri, Amdouni Nesrine, Kaddoussi Rania, Ahlem Bellalah, Kortas Chokri, Achour Asma, Joober Sameh, and Maatouk Faouzi. "Case Report: Mitral valve obstruction by metastatic malignant phyllodes tumor." F1000Research 11 (July 25, 2022): 309. http://dx.doi.org/10.12688/f1000research.110022.2.

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Cardiac metastases are rare. Herein, we report a case of a 37-year-old female patient with a history of borderline breast phyllodes tumor (PT) treated by surgery, admitted to our department for concomitant cardiac and pulmonary metastases of malignant PT. Cardiac metastasis occurred through direct extension from pulmonary metastasis to the left atrium via the right inferior pulmonary vein, causing severe mitral valve obstruction. Although the total surgical removal of metastases, the patient had a huge relapse of the mediastinal metastasis resulting in her death.
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Koyama, Ryota, Yoshiaki Maeda, Nozomi Minagawa, Toshiki Shinohara, and Tomonori Hamada. "Late Cutaneous Metastasis Originating from Gastric Cancer with Synchronous Metastasis." Case Reports in Gastroenterology 13, no. 1 (February 26, 2019): 95–101. http://dx.doi.org/10.1159/000497099.

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An 89-year-old man was diagnosed with late cutaneous metastasis in the right axilla 6 years after undergoing a surgery for gastric cancer with synchronous cutaneous metastasis in the same site. The patient became aware of small reddish nodules in the right axilla, and computed tomography imaging showed an irregular thickening of the right axillary skin. No other sign of recurrence was observed. By en-bloc resection, the nodules were diagnosed as late cutaneous metastasis from gastric cancer. The patient received no additional postoperative chemo- or radiotherapy and was only carefully observed. Cutaneous metastases from gastric cancer have a high recurrence rate even if total resection with no residual cancer is achieved. Therefore, meticulous follow-up, including routine visual inspection, is required for the early detection of late cutaneous metastases.
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Gusho, Charles A., Alan T. Blank, and Marta Batus. "Outcomes of brain metastasis in high-grade bone and soft tissue sarcoma: An analysis of clinicopathological characteristics and survival data." Rare Tumors 13 (January 2021): 203636132110261. http://dx.doi.org/10.1177/20363613211026151.

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Brain metastases in sarcoma are exceedingly rare, with few published series documenting ranges from 1% to 8%. This study investigated the outcomes of sarcoma patients with brain metastases using a population-based analysis. This was a retrospective review of 5933 patients with high-grade sarcoma identified from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. Of the eligible 5933 patients, 0.7% ( n = 44) had brain metastasis. Kaplan–Meier was used to estimate survival and follow-up (reverse Kaplan–Meier), and a multivariable Cox proportional hazards model analyzed prognostic factors of disease-free survival (DFS). Median (IQR) follow-up of all eligible patients was 28 months (12; 47). Patients who developed brain metastasis had a higher proportion of N1 stage disease ( p < 0.001), as well as synchronous metastasis to bones, liver, and lungs compared to those without brain metastasis (all p < 0.001). The median (IQR) DFS with brain metastasis was 6 months (2; 12), and survival with brain metastasis was significantly worse than DFS in patients without brain metastasis ( p < 0.001). Among those with brain metastasis only, there was no difference in DFS with respect to sex, race, primary tumor origin, T stage or N stage disease, synchronous metastasis to bone, liver or lung, nor with respect to chemotherapy or radiation for treatment of the primary tumor (all p > 0.05). For sarcoma patients with brain metastasis, the outcomes are poor and do not appear to differ by clinicopathologic factors. However, patients with certain histologies and synchronous metastases may warrant more frequent surveillance as there was an association of brain metastasis with these factors.
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Takayanagi, Akio, Atsushi Takahashi, Wakako Yorozuya, Kou Okabe, Tomohito Kaji, and Yoshio Takagi. "The Usefulness of Positron Emission Tomography/Computed Tomography in the Diagnosis of Metastasis in Patients with Urothelial Carcinoma — A Secondary Publication." Urology Research 2, no. 1 (March 29, 2024): 7–12. http://dx.doi.org/10.26689/ur.v2i1.6504.

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Purpose: This study examined the usefulness of positron emission tomography (PET)/computed tomography (CT) in the diagnosis of metastasis in patients with urothelial carcinoma. Materials and methods: The subjects were patients who were newly diagnosed with urothelial carcinoma in our department on whom we performed CT and PET/CT to search for metastasis. Results: The median age of the 92 subjects was 71 years, and bladder and upper tract urothelial cancer were underlying diseases in 41 (46%) and 51 (54%) patients, respectively. In 66 (72%) of the 92 cases, no metastasis was observed by CT, while PET/CT revealed metastasis in 9 (14%). The 57 (86%) patients in whom both CT and PET/CT showed no metastasis underwent radical surgery, while 2 patients (4%) exhibited pathological lymph node metastasis. Of the 26 patients in whom CT revealed metastasis, PET/CT showed no metastasis in 3 (12%), and the absence of pathological metastasis was confirmed in all patients. Of the 23 patients found to have metastasis in both CT and PET/CT, metastasis that could not be identified by CT was discovered by performing PET/CT in 10 (43%) patients. PET/CT showed significantly higher diagnostic accuracy than CT alone (P < 0.01), with sensitivities of 94.1% and 67.6%, specificities of 100% and 94.8%, and accuracy rates of 97.8% and 84.7%, respectively. Conclusions: PET/CT of patients with urothelial cancer revealed that metastases that cannot be diagnosed by CT alone are found at a significant frequency. Since these metastases can affect treatment choices in patients with urothelial cancer, PET/CT is considered to be useful in diagnosing metastases in patients with urothelial cancer.
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Sahin, Hilal, Naim Ceylan, Selen Bayraktaroglu, and Recep Savas. "Cardiac metastasis of osteosarcoma." Open Medicine 5, no. 5 (October 1, 2010): 551–55. http://dx.doi.org/10.2478/s11536-010-1018-5.

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AbstractCardiac osteosarcoma metastasis is extremely rare and is documented in several case reports in the literature. The behaviour of osteosarcoma metastases is similar to the primary tumour. Thoracic non-enhanced computed tomography (CT) examination is beneficial in the detection of calcific cardiac metastases. In this case report, we describe a 29-year-old woman with cardiac osteosarcoma metastasis after 7 years of follow-up, compare the demographic features with previous cases and discuss the imaging findings.
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Elmesidy, Salah Eldeen, Mahmoud Abdelsalam, and Husam Zawam. "Brain metastasis in a series of NSCLC: Egyptian experience." Journal of Clinical Oncology 30, no. 15_suppl (May 20, 2012): e18001-e18001. http://dx.doi.org/10.1200/jco.2012.30.15_suppl.e18001.

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e18001 Background: Incidence of cerebral metastasis is increasing among lung cancer patients. Many factors have been reported associated with increase risk of brain metastasis. The aim of this retrospective analysis is to investigate the predictive factors for the development of brain metastasis in lung cancer patients. Methods: We retrospectively analyzed histologically proven lung cancer patients radiologically diagnosed of having brain metastases who presented to Kasr Al-Eini Center for Oncology (NEMROCK) in the period from 2004 till 2010, with follow up period of 6 months at least. The following factors were analyzed: age, gender, PS, smoking history, tumor size & grade preceding development of brain metastasis. Results: Our study included 403 patients. 67 patients (16.6%) experienced brain metastasis during the course of their disease. 40 (10%) patients had brain metastasis among other sites of distant spread at first presentation which represent 88.9% of patients presented with metastatic disease. In a median follow-up of 17.1 months (6-77) the time to develop brain metastasis (TTBM) for the whole group was 5 months (range 2-22 months) (95% CI : 4.3-7.7). The most important factor affecting the TTBM was the use of chemotherapy before developing brain metastasis with a median TTBM of 5.9 months (95%CI : 3.2-6.8) among those who received chemotherapy compared to 2 months among the patients who didn't receive chemotherapy (P= <0.0001). The second factor was PS at time of initial diagnosis (P= 0.027). The median OS after brain metastasis was 6 months (95% CI : 4.26-7.74). On univariate analysis, PS and use of chemotherapy after developing brain metastases showed statistically significant difference affecting OS. Conclusions: We concluded that PS as well as use of chemotherapy are the 2 main factors associated with shorter time to develop brain metastasis. PS and use of chemotherapy after developing brain metastases showed longer OS after developing brain metastases. Keywords: NSCLC, Brain metastasis, Egypt
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Ahmed, Mohamed E., Jack R. Andrews, Ahmed Mahmoud, Matthew Lee, Daniel S. Childs, Ayse T. Kendi, Geoffrey Johnson, et al. "Survival patterns based on site-specific visceral metastasis in patients with metastatic prostate cancer: Are outcomes of visceral metastases the same?" Journal of Clinical Oncology 41, no. 6_suppl (February 20, 2023): 269. http://dx.doi.org/10.1200/jco.2023.41.6_suppl.269.

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269 Background: Metastatic visceral involvement in prostate cancer patients conveys a poor prognosis. Survival patterns of site-specific visceral metastasis are poorly understood. Here, we sought to investigate survival patterns in prostate cancer patients according to their first detected site of visceral metastasis. Methods: Retrospectively, we identified 200 patients with visceral metastatic prostate cancer. Patients were divided into three groups according to first site detected with visceral metastases; first-site lung metastases, first-site brain metastases, and first-site liver metastases. Visceral metastases were detected on either conventional imaging (CT/MRI), metabolic imaging (C-11 choline), or PSMA PET-CT scan. Follow up duration of our study was 80 months. Results: Clinicopathological variables are shown. The K-M curve of overall survival of the entire cohort suggests better survival patterns in patients with first-site lung metastases compared to patients with first-site brain or liver metastases (p<0.0001). In subset analysis of patients with CRPC, the K-M curve of overall survival, which demonstrates better survival outcomes in patients with first-site lung metastases in comparison with patients with first-site brain or liver metastases (p<0.0001). Conclusions: Our data suggests that prostate cancer patients with visceral metastatic disease have different survival patterns according to the first site detected with visceral metastasis. In our cohort, patients with first-site lung metastasis demonstrated better survival outcomes than patients with first-site brain or liver metastasis. Further studies are warranted. [Table: see text]
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Tani, Shoichiro, Yutaka Morizaki, Kosuke Uehara, Ryoko Sawada, Hiroshi Kobayashi, Yusuke Shinoda, Hirotaka Kawano, and Sakae Tanaka. "Bone metastasis of limb segments: Is mesometastasis another poor prognostic factor of cancer patients?" Japanese Journal of Clinical Oncology 50, no. 6 (February 21, 2020): 688–92. http://dx.doi.org/10.1093/jjco/hyaa024.

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Abstract Objective In contrast to acrometastasis, defined as bone metastasis to the hand or foot, the frequency and prognosis of bone metastasis of other limb segments remain unclear. To compare prognosis according to sites of bone metastasis, we defined two new terms in this study: ‘mesometastasis’ and ‘rhizometastasis’ as bone metastasis of ‘forearm or lower leg’ and ‘arm or thigh’, respectively. Methods A total of 539 patients who were registered to the bone metastasis database of The University of Tokyo Hospital from April 2012 to May 2016 were retrospectively surveyed. All patients who were diagnosed to have bone metastases in our hospital are registered to the database. Patients were categorized into four groups according to the most distal site of bone metastases: ‘acrometastasis’, ‘mesometastasis’, ‘rhizometastasis’ and ‘body trunk metastasis’. Results The frequency of rhizometastasis (22.5%) or body trunk metastasis (73.1%) was significantly higher than that of acrometastasis (2.0%) or mesometastasis (2.4%). The median survival time after diagnosis of bone metastases for each group was as follows: 6.5 months in acrometastasis, 4.0 months in mesometastasis, 16 months in rhizometastasis, 17 months in body trunk metastasis and 16 months overall. In survival curve, there was a statistically significant difference between mesometastasis and body trunk metastasis. Conclusions Our findings suggest that ‘mesometastasis’ could be another poor prognostic factor in cancer patients and that patients with mesometastasis should receive appropriate treatments according to their expected prognosis.
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Tantraworasin, Apichat, Somcharoen Saeteng, Nirush Lertprasertsuke, Nuttapon Arayawudhikule, Choosak Kasemsarn, and Jayanton Patumanond. "Completely Resected N0 Non-Small Cell Lung Cancer: Prognostic Factors Affecting Long-Term Survival." ISRN Surgery 2013 (August 29, 2013): 1–7. http://dx.doi.org/10.1155/2013/175304.

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Background. Although early stage non-small cell lung cancer (NSCLC) has an excellent outcome and correlated with good long-term survival, up to 15 percent of patients still relapse postoperatively and die. This study is conducted to identify prognostic factors that may affect the long-term survival in completely resected N0 NSCLC. Methods. Medical records of 124 patients with completely resected N0 NSCLC were retrospectively reviewed. Prognostic factors affecting long-term survival were analyzed by the Kaplan-Meier method and Cox proportional hazards analysis. Results. Overall five-year survival rate was 48 percent. Multivariable analysis revealed stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases as significant prognostic factors affecting long-term survival. The hazard ratio (HR) of tumor necrosis, tumor recurrence, brain metastasis, adrenal metastases, and skin metastases was 2.0, 2.3, 7.6, 4.1, and 8.3, respectively, and all P values were less than 0.001. Conclusions. Our study shows stage of disease, tumor necrosis, tumor recurrence, brain metastasis, adrenal metastasis, and skin metastasis as the independent prognostic factors of long-term survival in pathological N0 NSCLC. Early stage NSCLC patients without nodal involvement or presented with tumor necrosis should benefit from adjuvant chemotherapy, and sites of metastasis could predict the long-term survival as described.
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Zuccato, Jeffrey, Yasin Mamatjan, Kenneth Aldape, and Gelareh Zadeh. "ECOA-8. Lung adenocarcinoma brain metastasis prediction using tumor DNA methylation profiling." Neuro-Oncology Advances 3, Supplement_2 (July 1, 2021): ii2. http://dx.doi.org/10.1093/noajnl/vdab070.008.

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Abstract Introduction The development of brain metastases from primary cancer profoundly impacts patient prognosis. Up to one quarter of lung cancers develop brain metastases and subsequent median overall survival is one year. Although clinical factors do not reliably predict brain metastasis development, DNA methylation signatures have been recently shown to predict outcomes in other cancers. It is hypothesized that DNA methylation signatures predicting brain metastasis development from lung cancer will be identified. This work may allow for treatment strategies that prevent brain metastasis development in high risk lung cancer patients. Methods DNA methylation profiling was undertaken on N=124 lung adenocarcinoma patients. In a randomly selected 70% training cohort, differentially methylated CpG sites between patients developing and not developing brain metastases were identified and used to build a generalized boosted regression model. Patients in the independent 30% testing cohort were assigned brain metastasis risk scores by the model. Results Brain metastases developed in 49/124 (39.5%) of patients and 2.3K CpG sites were significantly differentially methylated between patients developing and not developing metastases. Methylation-based brain metastasis risk scores predicted time to brain metastasis development in the testing cohort (Univariate cox: HR=3.2, 95% CI 1.1–9.4, p=0.03). A multivariate cox analysis assessing tumor size and nodal positivity together with methylation scores as covariates identified methylation scores as the only independent predictor of brain metastasis development in the testing cohort (HR=4.3, 95%CI 1.1–17, p=0.038). Conclusions DNA methylation signatures in lung adenocarcinomas predict brain metastasis development independently from the non-metastatic components of cancer stage. Future work developing a comprehensive nomogram utilizing methylation scores together with clinical factors to determine patient specific risk values may aid in treatment decisions and patient prognosis counselling.
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39

Kähkönen, Tiina E., Jussi M. Halleen, and Jenni Bernoulli. "Abstract A007: Preclinical bone metastasis technology platform – Predictive evaluation of experimental therapies on bone metastasis." Molecular Cancer Therapeutics 22, no. 12_Supplement (December 1, 2023): A007. http://dx.doi.org/10.1158/1535-7163.targ-23-a007.

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Abstract Most cancer deaths are due to metastases, and bone metastases are a considerable problem especially in breast and prostate cancer, being developed in 70-90% of advanced-stage patients. Despite major investments in oncology drug development, bone metastases are currently incurable and a high unmet medical need with only 5% of patients being alive 5 years after the diagnosis. Development of therapies for bone metastasis has been challenging due to lack of appropriate preclinical models available to support decision making in next phases of drug development. In the absence of clinically relevant preclinical bone metastasis models, the current strategy is to rely on preclinical efficacy data obtained with subcutaneous models that lack the clinically relevant local tissue microenvironment, which has a major impact on tumor growth. The use of clinically non-relevant models in preclinical-stage development may be one important reason for the current &gt;95% failure rate of oncology drugs in clinical trials. To support predictive evaluation of therapies for bone metastatic cancers, we describe a preclinical bone metastasis technology platform for evaluating efficacy of novel therapies on bone metastases. The platform utilizes tumors growing in bone microenvironment, mimicking growth of bone metastases in patients. Syngeneic or humanized mouse models with tumor and immune cells of same species are needed for supporting development of immunotherapies, allowing interactions of tumor and immune cells in the bone metastatic microenvironment, according to the novel osteoimmuno-oncology concept. The platform provides a predictive tool for studying unique biological features associated with different types of bone metastases in cancer-type specific manner. Here we summarize case examples where results from preclinical bone metastasis studies align with clinical findings of different therapies approved or evaluated for bone metastasis. Zoledronic acid, an anti-resorptive bisphosphonate that is currently used in breast cancer patients with bone metastases to prevent cancer-induced bone loss, showed improved bone health but no effects on tumor growth. Radium-223 dichloride, an approved treatment for bone metastatic castration-resistant prostate cancer in patients, showed reduced prostate cancer growth and decreased tumor-induced bone changes. As for immunotherapies, an IDO1 inhibitor had no effects on breast cancer bone metastases and the anti-PD-1 antibody pembrolizumab had no effects on breast and prostate cancer bone metastases, predicting recent clinical findings that demonstrate lack of efficacy of anti-PD-1 in clinical prostate cancer trials. We conclude that the bone metastasis technology platform is a biologically relevant tool for preclinical evaluation of the efficacy of experimental therapies on bone metastasis, and it has been validated with positive and negative case examples, demonstrating its clinically predictive power. Citation Format: Tiina E Kähkönen, Jussi M Halleen, Jenni Bernoulli. Preclinical bone metastasis technology platform – Predictive evaluation of experimental therapies on bone metastasis [abstract]. In: Proceedings of the AACR-NCI-EORTC Virtual International Conference on Molecular Targets and Cancer Therapeutics; 2023 Oct 11-15; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2023;22(12 Suppl):Abstract nr A007.
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40

Zhang, Peng, Weili Yang, Yingfeng Fu, Jun Zhang, Fan Feng, Gang Zhai, Yang Fu, et al. "Is lymph node metastasis an event indicating an advanced gastrointestinal stromal tumor?" Journal of Clinical Oncology 42, no. 3_suppl (January 20, 2024): 754. http://dx.doi.org/10.1200/jco.2024.42.3_suppl.754.

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754 Background: The clinicopathological features and prognosis of gastrointestinal stromal tumors (GISTs) with lymph node metastasis remain controversial owing to their low incidence. A multicenter retrospective cohort study was conducted to compare the clinicopathological features and oncologic outcomes of GIST with and without lymph node metastases. Methods: The medical records of patients with GISTs in 16 large medical centers in China from January 2014 to December 2020 were reviewed. Patients were divided into three groups: no metastasis, lymph node metastasis without distant metastasis, and distant metastasis without lymph node metastasis. Propensity score matching (PSM) was performed to reduce confounding factors. Results: A total of 1109 cases of primary GIST were included in this study, comprising 607 males (54.7%) and 502 females (45.3%), with a mean age of 56.6±11.9 years. There were 1024 patients (92.3%) with no lymph node metastasis after surgery, and 85 patients (7.7%) had lymph node metastasis. Compared to that in GIST without lymph node metastasis, the proportion of non-gastric GIST was higher in GIST with lymph node metastasis (52.9% vs. 40.7%) with a larger tumor diameter (>10 cm: 36.5% vs. 18.1%) and more patients with distant metastasis (11.8% vs. 3.5%). Tumor location not in the stomach, the largest tumor diameter, and distant metastasis were independent risk factors for GIST with lymph node metastasis (all P < 0.05). After PSM, 96, 48, 24 patients comprised no metastasis, lymph node metastasis without distant metastasis, and distant metastasis without lymph node metastasis, respectively. The relapse-free survival (RFS) of the lymph node metastasis group was comparable to that of the distant metastasis group without lymph node metastasis ( P = 0.368) and significantly inferior to that of no metastases ( P = 0.042). Conclusions: The prognosis of patients with GIST with lymph node metastasis was comparable to that of patients with distant metastasis and significantly worse than that of patients without metastasis. Lymph node metastasis may be an advanced event in GIST.
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Decoene, Jasper, Filip Ameye, Evelyne Lerut, Raymond Oyen, Hein Van Poppel, and Steven Joniau. "Renal Cell Carcinoma with Synchronous Metastasis to the Calcaneus and Metachronous Metastases to the Ovary and Gallbladder." Case Reports in Medicine 2011 (2011): 1–4. http://dx.doi.org/10.1155/2011/671645.

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Renal cell carcinomas (RCCs) are known for their unpredictable metastatic pattern. We present the case of a 63-year-old woman who initially presented in 1992 with a metastasis in the left calcaneus that led to the discovery of RCC. In 1998, a new metastasis was found in the ovary. In 2008, the diagnosis of a gallbladder metastasis was made. All metastases were surgically removed; no additional systemic therapies were used. Aggressive surgical treatment can prolong the survival of patients with resectable metastases. Patterns of metastasis are discussed, and a brief review of the literature is given regarding each localization.
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42

Kandagatla, Pridvi, Lilias H. Maguire, and Karin M. Hardiman. "Biology of Nodal Spread in Colon Cancer: Insights from Molecular and Genetic Studies." European Surgical Research 59, no. 5-6 (2018): 361–70. http://dx.doi.org/10.1159/000494832.

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Colorectal cancer (CRC) lymph node metastases are common but their genetics and the mechanism whereby these metastases occur are not well understood. Here we present recent data regarding genetic heterogeneity in primary CRCs and their metastasis. In addition, we explain the different potential models describing the mechanisms of metastasis and the data supporting them. Multiple studies have also revealed a variety of prognostic molecular markers that are associated with lymph node metastasis in CRC. A better understanding of genetic heterogeneity and the mechanisms of metastasis is critical to predicting clinical response and resistance to targeted therapy.
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Kadi, N., M. Isherwood, M. Al-Akraa, and S. Williams. "Port-Site Metastasis after Laparoscopic Surgery for Urological Malignancy: Forgotten or Missed." Advances in Urology 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/609531.

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Purpose. Port-site metastasis has been a concern with the common use of laparoscopy in urologic oncology. We conducted this study to provide a review of port-site metastases reported after the laparoscopy in managing urologic malignancies, possible contributing factors and preventative measures.Materials and Methods.An electronic search of MEDLINE using the combined MESH key words “port-site metastasis” and “Urology”.Results. 51 articles addressing port-site metastasis after laparoscopic surgery for urolo¬gical malignancy were identified.Conclusion. Port-site metastasis after laparoscopic surgery for urolo¬gical malignancy is rare. The incidence is comparable to the rate for surgical wound metastases.
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Zhang, Luyan, Xifa Wu, Yong Feng, Linlin Zheng, and Jinbo Jian. "Selenium donors inhibits osteoclastogenesis through inhibiting IL-6 and plays a pivotal role in bone metastasis from breast cancer." Toxicology Research 9, no. 4 (July 2020): 544–51. http://dx.doi.org/10.1093/toxres/tfaa053.

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Abstract Bone metastases are a frequent complication of breast cancer, and there has been little progress in the treatment of breast cancer patients with bone metastases. The cytotoxicity of selenium donors, including organic selenium and selenium nanoparticles (SeNPs), to cancer cells has been reported previously, but their relationship with bone metastases progression is not fully clear yet. In this study, multicenter clinical exploration was conducted to obtain dietary selenium intakes of breast cancer patients with or without bone metastasis, to study the relationship between selenium and breast cancer prognosis and bone metastasis. We found that dietary selenium intakes were significantly lower in breast cancer patients with bone metastasis, comparing with the non-bone metastasis cases. Selenium lower group of bone metastasis breast cancer patients had worse prognosis, whereas the daily selenium intakes could not predict the prognosis of breast cancer patients without bone metastasis. Subsequently, we study the regulatory role of selenium donors on bone metastasis at the cellular level, by challenging the cells with SeNPs. SeNPs showed potent cytotoxicity in breast cancer cells, no matter whether they were primary or bone-metastatic. SeNPs treated cancer cell inhibited the survival and differentiation of osteoclast progenitor cells. At the molecular level, we demonstrated that IL-6 partially mediated osteoclastogenesis suppression by SeNPs. These results provide a new way for biomarkers or drug development to treat and even prevent bone metastases of breast cancer by using selenium donors.
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Arici, Akgul. "Clinicopathological features of our renal cell carcinoma metastasis cases: A single-center experience." Medicine Science | International Medical Journal 12, no. 4 (2023): 1140. http://dx.doi.org/10.5455/medscience.2023.08.158.

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Renal cell carcinoma (RCC) is the most common renal tumor in adults, arising from renal tubular epithelial cells. Approximately 30% of patients with RCC have metastases at the time of diagnosis, while metastases can be seen in 40% of patients during follow-up after nephrectomy. Metastases most commonly occur in the lung, bone, and lymph nodes. In our study, we aimed to retrospectively examine the cases diagnosed with RCC metastasis and evaluate their clinicopathological features. Age, gender, metastasis site, number of metastatic foci, localization of primary kidney tumor, histopathological type of primary kidney tumor, diameter of primary kidney tumor, grade of primary kidney tumor, and survival status of 52 patients diagnosed with RCC metastasis were recorded. Eleven (21.2%) of the cases had primary RCC and simultaneous (synchronous) RCC metastasis in the kidney. In 27 (51.9%) cases, RCC metastasis was detected in the follow-up period (metachronous) after nephrectomy due to the diagnosis of primary. The number of patients who were initially diagnosed with RCC metastasis and then were found to have primary RCC in the kidney was 14 (26.9%). Thirty-nine (75%) cases had a single metastatic focus. Metastasis site distribution of the cases; bone 18 (34.6%), lung 16 (30.8%), lymph nodes 8 (15.4%), liver 6 (11.5%), adrenal gland 6 (11.5%), brain 4 (7.7%) was. RCC metastases can occur as metastatic disease before primary tumor diagnosis, at the time of primary tumor diagnosis, or years after nephrectomy.
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He, Chunyu, Guliqihere Mamuti, Munire Mushajiang, and Simayili Maimatiniyazi. "Risk factors and prognostic factors of brain metastasis of triple-negative breast cancer: A single-center retrospective study." Journal of Cancer Research and Therapeutics 20, no. 4 (August 2024): 1314–22. http://dx.doi.org/10.4103/jcrt.jcrt_2079_21.

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ABSTRACT Objective: This retrospective study is to explore the risk factors and prognostic factors of brain metastases of triple-negative breast cancer (TNBC) in a single center. Methods: Clinical data of patients with stages I–III TNBC were collected. The Kaplan-Meier method, log-rank test, and stepwise COX regression were performed. Results: The 437 patients with stages I–III TNBC were followed up for five years. Among them, 89 cases (20.4%) developed brain metastases, and they were followed up for 2 years after brain metastasis. The cumulative brain metastasis rates of TNBC patients at six months, one year, two years, three years, and five years were 1.38%, 5.75%, 12.94%, 17.63%, and 21.26%, respectively. Multivariate analysis suggested that the first diagnosis age ≤35 years old, advanced pathological stage, lymph node metastasis, and Ki-67 ≥30% represented the risk factors for brain metastasis. In contrast, the surgical method was a protective factor for brain metastasis. The median survival time after brain metastasis was 4.87 months. The survival rates at one, three, six, 12, and 24 months were 84.27%, 60.67%, 34.83%, 15.69%, and 6.64%, respectively. The age >60 years at first diagnosis, Ki-67 ≥30%, local recurrence, and distant metastasis were closely related to the poor prognosis of TNBC patients with brain metastases, while radiotherapy alone, systemic therapy, and combined chemotherapy and radiotherapy represented the prognostic protective factors. Conclusions: Patient age, Ki-67 level, metastasis, and treatment methods are the risk factors and prognostic factors for brain metastasis of TNBC. Surgical resection of the primary lesion during the first treatment is essential to reduce the incidence of brain metastases. Close postoperative follow-up (such as brain magnetic resonance imaging [MRI]) within 2–3 years after surgery is recommended to improve the prognosis.
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Fang, Yanman, Hushan Zhang, Jiali Zou, Fulin Zhou, Xuejie Tang, Yi Yang, Li Luo, and Yu Ding. "Abstract 5983: Gene profile analysis of breast cancer lung metastasis, liver metastasis, brain metastasis and primary tumor." Cancer Research 82, no. 12_Supplement (June 15, 2022): 5983. http://dx.doi.org/10.1158/1538-7445.am2022-5983.

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Abstract Background: The incidence of male breast cancer (MBC) is lower than female breast cancer (FBC), representing 1% of all breast cancer worldwide. The difference with FBC may affect the treatment strategy of MBC, but the necessary precondition is that we should know more about the difference between FBC and MBC. However, Because of its low incidence that the relevant data about MBC is relatively scarce. Here we report some data about gene mutation of MBC, and compared it with FBC. Methods: Blood or tumor Tissue samples of breast cancer were collected and subjected to NGS in a College of American Pathologists (CAP)-certified and Clinical Laboratory Improvement Amendments (CLIA)-accredited lab for gene mutation analysis (3D Medicines Inc.,Shanghai, China). Statistical analysis was performed using GraphPad Prism (version 7.01) and SPSS version 21.0 (SPSS,Inc.). Results: Approximately 182 samples were analyzed, among which, exist 82 samples were from primary tissue, 66 samples were breast cancer liver metastases, 20 were lung metastases and 14 were brain metastases. High genomic heterogeneity was found among primary breast cancer tissue, breast cancer liver metastases, lung metastases, brain metastases, that is at least 20 gene mutations were found in these BC samples, while different gene mutations were showed among primary and different metastases tissues. The top five mutated gene in primary tumor tissue were TP53(80.49%), PIK3CA(53.66%), FGF19(30.49%), ERBB2(26.83%), MYC(23.17%); in liver metastases tissues were TP53(54.55%), FGF19(39.39%), PIK3CA(37.88%), ERBB2(21.21%), CCND1(19.70%); in lung metastases tissues were TP53(70.00%), PIK3CA(55.00%), ERBB2,MCL1(25.00%), CDKN2A/2B(20.00%), CCND1, NF1, CDK12(15.00%), CCND2, MYC, PTEN, GNAS, FGF19, PTK2, FGFR1(10.00%); in brain metastases tissues were TP53(42.86%), PIK3CA(28.57%), ZNF703, PREX2, JAK3, MYC, FGFR1(14.29%). Besides, levels of TMB were also different among primary tissue, liver, lung and brain metastases tissues. Higher TMB level were showed in liver and brain metastases tissue than primary and lung metastases tissues (p&lt;0.001). Conclusions: Different metastases of breast cancer were different in gene mutation landscape, this imply these patients should be managed differently. Citation Format: Yanman Fang, Hushan Zhang, Jiali Zou, Fulin Zhou, Xuejie Tang, Yi Yang, Li Luo, Yu Ding. Gene profile analysis of breast cancer lung metastasis, liver metastasis, brain metastasis and primary tumor [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5983.
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48

Fendt, Sarah-Maria. "Abstract PL04-03: Metastasis aggressiveness: A function of metabolite signaling." Cancer Research 84, no. 7_Supplement (April 5, 2024): PL04–03—PL04–03. http://dx.doi.org/10.1158/1538-7445.am2024-pl04-03.

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Abstract Metastasis formation is the leading cause of death in cancer patients. Yet, the molecular mechanisms responsible for the aggressiveness of metastases remain largely unknown. We used experimental metastasis mouse models and samples from patients with breast cancer to study metastases aggressiveness. We discovered that the aggressiveness of cancer cells in lung metastases was driven by an alternative translational program that was regulated by metabolite signaling. Strikingly, the identified molecular mechanism could be disrupted by repurposing a clinical approved inhibitor, which resulted in reduced metastasis formation in mouse models. Thus, this research highlights that dissecting and targeting cancer cell aggressiveness may provide therapeutic options against metastasis formation. Citation Format: Sarah-Maria Fendt. Metastasis aggressiveness: A function of metabolite signaling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr PL04-03.
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49

Yakar, Melek, and Durmuş Etiz. "Prognostic factors of breast cancer brain metastasis." World Journal of Clinical Oncology 15, no. 1 (January 24, 2024): 5–8. http://dx.doi.org/10.5306/wjco.v15.i1.5.

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In this editorial we comment on the article by Chen et al published in the recent issue of the World Journal of Clinical Oncology . Brain metastasis is one of the most serious complications of breast cancer and causes high morbidity and mortality. Brain metastases may involve the brain parenchyma and/or leptomeninges. Symptomatic brain metastases develop in 10%-16% of newly recognized cases each year, and this rate increases to 30% in autopsy series. Depending on the size of the metastatic foci, it may be accompanied by extensive vasogenic edema or may occur as small tumor foci. Since brain metastases are a significant cause of morbidity and mortality, early diagnosis can have significant effects on survival and quality of life. The risk of developing brain metastases emerges progressively due to various patient and tumor characteristics. Patient variability may be particularly important in the susceptibility and distribution of brain metastases because malignant blood must cross the brain barrier and move within the brain parenchyma. Some characteristics of the tumor, such as gene expression, may increase the risk of brain metastasis. Clinical growth, tumor stage, tumor grade, growth receptor positivity, HER2 positivity, molecular subtype (such as triple negative status, luminal/nonluminal feature) increase the risk of developing breast cancer metastasis. Factors related to survival due to breast cancer brain metastasis include both tumor/patient characteristics and treatment characteristics, such as patient age, lung metastasis, surgery for brain metastasis, and HER2 positivity. If cases with a high risk of developing brain metastasis can be identified with the help of clinical procedures and artificial intelligence, survival and quality of life can be increased with early diagnosis and treatment. At the same time, it is important to predict the formation of this group in order to develop new treatment methods in cases with low survival expectancy with brain metastases.
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50

Zuccato, Jeffrey, Yasin Mamatjan, Kenneth Aldape, and Gelareh Zadeh. "CMET-32. DNA METHYLATION ALTERATIONS IN LUNG ADENOCARCINOMAS THAT DEVELOP BRAIN METASTASES." Neuro-Oncology 21, Supplement_6 (November 2019): vi58. http://dx.doi.org/10.1093/neuonc/noz175.233.

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Abstract INTRODUCTION The development of brain metastases from primary cancer profoundly impacts patient prognosis. Metastases are the most common adult brain tumor with up to one quarter of lung cancers developing metastases and median overall survival after metastasis being one year. Clinical factors do not reliably predict brain metastasis development and over 90% are identified after symptoms develop. DNA methylation signatures predict outcomes in other cancers and so identifying signatures that predict metastasis development may allow for treatment strategies that prevent development in high risk patients. METHODS Whole genome DNA-methylation profiling was undertaken on N=124 lung adenocarcinoma patients after bisulfite conversion of DNA from formalin-fixed paraffin-embedded tissue. In a randomly selected 70% training cohort, the most differentially methylated CpG sites between patients developing and not developing brain metastases were identified with p< 0.05. A generalized boosted regression model built on these selected features output brain metastasis risk scores for patients in the independent 30% testing cohort. RESULTS Brain metastases developed in 49/124 (39.5%) of patients and 2.3K CpG sites were significantly differentially methylated between patients developing and not developing metastases. Methylation-based brain metastasis risk scores predicted time to brain metastasis in a univariate cox regression model (HR=3.2, 95% CI 1.1–9.4, p=0.03). A corresponding area under the receiver operating characteristic curve at 52 months was 0.64. A multivariate cox analysis including tumor size and nodal status, representing the non-metastatic components of cancer stage, identified methylation score as the only independent predictor of brain metastasis (HR=4.3, 95%CI 1.1–17, p=0.038). CONCLUSIONS DNA methylation signatures in lung adenocarcinoma predict brain metastasis development independent of stage components, which classically predict patient outcome in cancer. Future work developing a comprehensive nomogram utilizing methylation scores together with other clinical factors to determine patient specific risk values may aid in treatment decisions and patient prognosis counselling.
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