Here is the metastasis - find the primary carcinoma for it: a large biopsy study

Yıl 2023, Cilt: 9 Sayı: 2, 309 - 316, 04.03.2023

Çiğdem Özdemir , Yiğit Şenol , Meltem Baykara , Mehmet Olgun Ak , Hacer Demir , Yasin Sarıkaya

https://doi.org/10.18621/eurj.1240493

Öz

Objectives: According to estimates, cancer of unknown primary origin (CUP) accounts for approximately 3 to 5% of new cancer cases annually in the United States. With early diagnosis, many CUP patients can achieve long-term remission. The aim of this study was to document the organ tropism for metastasis for tumors with a definite primary cancer. In addition, we sought to contribute to understanding organ tropism in tumors of unknown origin.

Methods: Retrospectively, biopsies of 492 metastatic cancers were evaluated. The required immunohistochemical panel was applied to determine the tumors’ origins.

Results: A total of 492 patients with metastases were included in the study. The most common origins of metastasizing tumors were lung (25.4%), colon (18.9%), breast (15.4%) and stomach cancers (10.6%). The least metastatic tumors were the salivary gland, neuroendocrine, adrenal, tubal, nasopharynx, rectum and esophagus cancers (0.22% for all). The most common cancers that metastasized to the liver were colon cancer (29.0%), stomach cancer (18.6%) and pancreatic cancer (18.6%). The most common cancers that metastasized to the bone were lung cancer (58.0%), breast cancer (29.0%), and prostate cancer (13.9%). The most common types of tumors that metastasized to the lungs, the kidney (35.1%), colon (29.7%), and breast cancers (16.2%), were the most common. The most common tumors that metastasized to the brain were the lung (61.1%), the breast (16.7%), and kidney cancers (8.7%). The most common tumors metastasizing to the skin were lung (31.0%), breast (27.6%), and colon (13.8%) cancers.

Conclusions: Primary cancers have different metastatic patterns, which may help determine their causes. By involving distant anatomical structures and disrupting their function, tumor metastases increase the morbidity and mortality associated with the disease; thus, they affect staging, prognosis, and treatment. Metastases (or cancers from unknown primary sites) usually require extensive investigation to determine their primary source. Whether the cancer is tracked prospectively or retrospectively, a detailed observational template highlighting expected metastatic patterns would greatly assist in diagnosis and treatment.

Anahtar Kelimeler

Cancer of unknown primary origin, organ tropism, metastasis.

Kaynakça

• 1. Seyfried TN, Huysentruyt LC. On the origin of cancer metastasis. Crit Rev Oncog 2013;18:43-73.
• 2. Pavlidis N, Pentheroudakis G. Cancer of unknown primary site. Lancet. 2012;379:1428-35.
• 3. Gupta GP, Massagué J. Cancer metastasis: building a framework. Cell 2006;127:679-95.
• 4. Fidler IJ. Critical determinants of metastasis. Semin Cancer Biol 2002;12:89-96.
• 5. Disibio G, French SW. Metastatic patterns of cancers: results from a large autopsy study. Arch Pathol Lab Med 2008;132:931-9.
• 6. Riihimäki M, Thomsen H, Sundquist K, Sundquist J, Hemminki K. Clinical landscape of cancer metastases. Cancer Med 2018;7:5534-42.
• 7. Koşaloğlu-Yalçın Z, Blazeska N, Vita R, Carter H, Nielsen M, Schoenberger S, et al. The Cancer Epitope Database and Analysis Resource (CEDAR). Nucleic Acids Res 2023;51(D1):D845-D52.
• 8. Sokolova A, Johnstone KJ, McCart Reed AE, Simpson PT, Lakhani SR. Hereditary breast cancer: syndromes, tumour pathology and molecular testing. Histopathology 2023;82:70-82.
• 9. Holmes FF, Fouts TL. Metastatic cancer of unknown primary site. Cancer 1970;26:816-20.
• 10. Gao Y, Bado I, Wang H, Zhang W, Rosen JM, Zhang XH-F. Metastasis organotropism: redefining the congenial soil. Dev Cell 2019;49:375-91.
• 11. Mortezaee K. Organ tropism in solid tumor metastasis: an updated review. Future Oncol 2021;17:1943-61.
• 12. Obenauf AC, Massagué J. Surviving at a distance: organ-specific metastasis. Trends Cancer 2015;1:76-91.
• 13. de Ridder J, de Wilt JH, Simmer F, Overbeek L, Lemmens V, Nagtegaal I. Incidence and origin of histologically confirmed liver metastases: an explorative case-study of 23,154 patients. Oncotarget 2016;7:55368.
• 14. Coleman R. Metastatic bone disease: clinical features, pathophysiology and treatment strategies. Cancer Treat Rev 2001;27:165-76.
• 15. Ulucaköy C, Yapar A, Şeyhoğlu MC, Tokgöz MA, Atalay İB, Güngör BŞ. [Demographic Features of Metastatic Bone Tumors]. Acta Oncol Tur 2021;54:98-102. [Article in Turkish]
• 16. Yavaşoğlu F, Özdemir Ç. [Patients with carcinoma metastasis diagnosed by bone marrow biopsy]. Osmangazi Tıp Dergisi 2022;44:211-6. [Article in Turkish]
• 17. Teyateeti P, Ungtrakul T. Retrospective review of cutaneous metastasis among 11,418 patients with solid malignancy: a tertiary cancer center experience. Medicine 2021;100:e26737.
• 18. Wong CY, Helm MA, Helm TN, Zeitouni N. Patterns of skin metastases: a review of 25 years' experience at a single cancer center. Int J Dermatol 2014;53:56-60.
• 19. Dumlao JKG, Cubillan ELA, Villena JPDS. Clinical and histopathologic profile of patients with cutaneous metastasis in a tertiary hospital in the Philippines. Dermatopathology (Basel) 2022;9:392-407.
• 20. Sanmartin MC, Borzone FR, Giorello MB, Pacienza N, Yannarelli G, Chasseing NA. Bone marrow/bone pre-metastatic niche for breast cancer cells colonization: the role of mesenchymal stromal cells. Crit Rev Oncol Hematol 2021;164:103416.
• 21. Germans SK, Weinberg OK. Metastatic angiosarcoma in a bone marrow biopsy. Blood2022;140:2001.
• 22. Ozkalemkas F, Ali R, Ozkocaman V, Ozcelik T, Ozan U, Ozturk H, et al. The bone marrow aspirate and biopsy in the diagnosis of unsuspected nonhematologic malignancy: a clinical study of 19 cases. BMC Cancer 2005;5:144.