Origins of lymphatic and distant metastases in human colorectal cancer

Author:

Naxerova Kamila12ORCID,Reiter Johannes G.3ORCID,Brachtel Elena4,Lennerz Jochen K.4ORCID,van de Wetering Marc56ORCID,Rowan Andrew7ORCID,Cai Tianxi8ORCID,Clevers Hans56ORCID,Swanton Charles79ORCID,Nowak Martin A.310ORCID,Elledge Stephen J.211ORCID,Jain Rakesh K.1ORCID

Affiliation:

1. Edwin L. Steele Laboratories for Tumor Biology, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.

2. Division of Genetics, Department of Genetics, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA.

3. Program for Evolutionary Dynamics, Harvard University, Cambridge, MA 02138, USA.

4. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.

5. Hubrecht Institute, Royal Netherlands Academy of Arts and Sciences (KNAW) and University Medical Center (UMC) Utrecht, 3584CT Utrecht, Netherlands.

6. Cancer Genomics Netherlands, UMC Utrecht, 3584CG Utrecht, Netherlands.

7. The Francis Crick Institute, London NW1 1AT, UK.

8. Department of Biostatistics, Harvard University, Boston, MA 02115, USA.

9. University College London Cancer Institute, London WC1E 6DD, UK.

10. Department of Mathematics and Department of Organismic and Evolutionary Biology, Harvard University, Cambridge, MA 02138, USA.

11. Howard Hughes Medical Institute, Harvard Medical School, Boston, MA 02115, USA.

Abstract

Metastases undergo reconstruction Cancer cells from primary tumors can migrate to regional lymph nodes and distant organs. The prevailing model in oncology is that lymph node metastases give rise to distant metastases. This “sequential progression model” is the rationale for surgical removal of tumor-draining lymph nodes. Naxerova et al. used phylogenetic methods to reconstruct the evolutionary relationship of primary tumors, lymph node metastases, and distant metastases in 17 patients with colorectal cancer (see the Perspective by Markowitz). The sequential progression model applied to only one-third of the patients. In the other two-thirds, distant metastases and lymph node metastases originated from independent subclones within the primary tumor. Science , this issue p. 55 ; see also p. 35

Funder

U.S. Department of Defense

National Human Genome Research Institute

Francis Crick Institute

National Cancer Institute

Austrian Science Fund

Ludwig Institute for Cancer Research

Publisher

American Association for the Advancement of Science (AAAS)

Subject

Multidisciplinary

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