scholarly journals LATE LIVER METASTASIS 20 YEARS AFTER THE INITIAL DIAGNOSIS: A CASE REPORT OF METACHRONOUS HORMONE DEPENDENT TUMORS OF BREAST AND ENDOMETRIUM

2021 ◽  
pp. 56
Author(s):  
Ivan Ilić ◽  
Maja Jovičić Milentijević ◽  
Aleksandar Milićević ◽  
Milica Stanković ◽  
Aleksandra Radičević
Keyword(s):  
Breast Cancer ◽  
Liver Metastasis ◽  
Liver Biopsy ◽  
Cancer Metastasis ◽  
Primary Diagnosis ◽  
Initial Diagnosis ◽  
Female Population ◽  
Secondary Tumor ◽  
Breast Malignancy ◽  
Increased Risk

Breast cancer is the most common cancer and a significant cause of morbidity and mortality in female population worldwide. The liver is the third most common metastatic site for invasive breast malignancy besides bones, lungs and brain. Breast cancer has been linked with metachronous bone, endometrial, colon/rectal, connective tissue (sarcoma), leukemia, lung, ovary or thyroid cancer. Studies have shown an increased risk of secondary malignancies in women treated for breast malignancy in connection to adjuvant treatment in certain cases. We present a case of a 71 year old woman who was diagnosed with breast cancer 20 years ago. The primary diagnosis was invasive lobular breast cancer localized in left lower lateral quadrant. Micromorphological, histochemical and immunohistochemical analyses rendered diagnosis inconclusive due to lack of tissue so after 4 months rebiopsy was performed. Clinico-pathological correlation of the second biopsy was in favor of liver metastasis of partially hormone dependent breast cancer. Immunohistochemistry was vital for the diagnosis on the liver biopsy, in particular GATA3 positivity and vimentin negative staining which helped us exclude endometrial cancer metastasis which was diagnosed before the initial liver biopsy. GATA 3(+)/vimentin(-) panel proved to be superior to GCDFP-15 and mammaglobin in proving the breast origin of  the secondary tumor deposit.Liver metastasis from primary breast cancer can in certain cases occur many years after the initial diagnosis which shows the importance and necessity for long term follow-up of these patients, while considering the possibility of metachronous tumors as well.

Exploring the determinants of delayed diagnosis of breast cancer in the female population of Punjab (Pakistan)

2021 ◽  
Author(s):  
Samina Farooqi ◽  
Samina Kausar ◽  
Kalsoom Bibi ◽  
Zunaira Aziz ◽  
Tahira Rehmat
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Cancer Metastasis ◽  
Delayed Diagnosis ◽  
Care Facility ◽  
Breast Cancer Metastasis ◽  
Diagnosis Delay ◽  
Breast Cancer Patients ◽  
Related Factors ◽  
Female Population

ABSTRACT Objective: To explore the factors contributing to late diagnosis of breast cancer in female population of Punjab, Pakistan. Methodology: Descriptive qualitative study with phenomenological approach was used. The study was carried out in University of Health Sciences, Lahore in collaboration with breast cancer clinics/departments of the Jinnah Hospital, Lahore, Sir Ganga Ram Hospital Lahore and Mayo Hospital Lahore. 15 Females diagnosed more than 4 months after appearance of symptoms of breast cancer were recruited using purposive sampling until saturation of data. Data collected through in depth semi structured face to face interviews was tape-recorded, transcribed and then analysed using thematic analysis framework method. Results: Personal/psychological factors, Sociocultural and Health care system related factors were identified as main themes emerged from data. Lack of knowledge, religious believes, use of Alternative medicine, socioeconomic status cultural myths and poorly facilitated health care facility were the most influential determinants of delay among breast cancer patients. Conclusion: Diagnosis delay is very significant health problem in women with breast cancer linked with multiple determinants. However, educating women for recognition of symptoms and reinforcement to pursue for earlier medical consultation will be helpful in reducing breast cancer diagnosis delay in the country. Key terms: Breast Cancer, Metastasis, Delayed Diagnosis, Prognosis, Advance Stage.

Persistence of disseminated tumor cells (DTC) in bone marrow (BM) of breast cancer patients predicts increased risk for relapse—Results of pooled European data

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10083-10083 ◽  
Author(s):  
W. J. Janni ◽  
G. Wiedswang ◽  
T. Fehm ◽  
J. Jueckstock ◽  
E. Borgen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Prognostic Significance ◽  
Primary Diagnosis ◽  
Nodal Status ◽  
Breast Cancer Patients ◽  
Increased Risk

10083 Background: The prognostic significance of DTC in the BM of breast cancer patients at the time of primary diagnosis has recently been confirmed by a large pooled analysis. If the persistence of DTC after adjuvant therapy confers a similar risk for relapse, there might be an indication for secondary adjuvant treatment. Methods: We analyzed BM aspirates of 697 patients from academic breast cancer units in Oslo (n=356), Munich (n=228) and Tuebingen (n=113) during recurrence-free follow-up at a median interval of 32.4 months (standard deviation [std] 19.4 mon) after primary diagnosis of breast cancer pT1–4, pN0–3 pM0. Carcinoma cells were detected using a standardized immunoassay with the monoclonal antibodies A45-B/B3 (Munich, Tuebingen), or AE1 and AE3 (Oslo), directed against cytokeratin (CK). Patients were followed for a median of 54.2 months (std 24.5 mon) after primary diagnosis. Results: Persistent DTC in the BM were detected in 15.6% of the patients (n=109). The Kaplan-Meier estimate for mean distant relapse-free survival estimate was 155.6 mon (142.4 - 168.9 95%CI) in patients with negative and 102.3 mon (93.6 - 111.0, 95% CI, p< .0001, log rank test) in patients with positive BM status. Patients without evidence of persistent DTC had a significantly longer overall survival (164.4 [155.6 - 173.3]), than patients with positive BM status (101.7 mon [89.4 - 113.9], p< .0001). In multivariate Cox regression analysis, allowing for bone marrow status, tumor size, nodal status, histopathological grading and hormone receptor status, DTC was of higher independent prognostic significance for subsequent reduced breast cancer specific survival (RR 5.9, 2.8 - 12.8, 95% CI, p< .0001), than nodal status at time of primary diagnosis (RR 1.2, 1.0 - 1.3, 95% CI, p=.014). Conclusion: Evidence of persistent DTC in breast cancer patients indicates an increased risk for subsequent relapse, and may serve for monitoring in future clinical trials. Such trials might investigate the benefit of individualized secondary adjuvant treatment or extended adjuvant therapy of patients with DTC. No significant financial relationships to disclose.

scholarly journals Hepatectomy, RFA, and Other Liver Directed Therapies for Treatment of Breast Cancer Liver Metastasis: A Systematic Review

2021 ◽  
Vol 11 ◽  
Author(s):  
Kevin Rivera ◽  
Dhiresh Rohan Jeyarajah ◽  
Kimberly Washington
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Liver Metastasis ◽  
Hepatic Resection ◽  
Cancer Metastasis ◽  
Cochrane Review ◽  
Hepatic Arterial Infusion ◽  
Breast Cancer Metastasis ◽  
Arterial Infusion ◽  
Breast Cancer Liver Metastasis

BackgroundThe liver is the second most common site of breast cancer metastasis. Liver directed therapies including hepatic resection, radiofrequency ablation (RFA), transarterial chemo- and radioembolization (TACE/TARE), and hepatic arterial infusion (HAI) have been scarcely researched for breast cancer liver metastasis (BCLM). The purpose of this review is to present the known body of literature on these therapies for BCLM.MethodsA systematic review was performed with pre-specified search terms using PubMed, MEDLINE, EMBASE, and Cochrane Review resulting in 9,957 results. After review of abstracts and application of exclusion criteria, 51 studies were included in this review.ResultsHepatic resection afforded the longest median overall survival (mOS) and 5-year survival (45 mo, 41%) across 23 studies. RFA was presented in six studies with pooled mOS and 5-year survival of 38 mo and 11–33%. Disease burden and tumor size was lower amongst hepatic resection and RFA patients. TACE was presented in eight studies with pooled mOS and 1-year survival of 19.6 mo and 32–88.8%. TARE was presented in 10 studies with pooled mOS and 1-year survival of 11.5 mo and 34.5–86%. TACE and TARE populations were selected for chemo-resistant, unresectable disease. Hepatic arterial infusion was presented in five studies with pooled mOS of 11.3 months.ConclusionAlthough further studies are necessary to delineate appropriate usage of liver directed therapies in BCLM, small studies suggest hepatic resection and RFA, in well selected patients, can result in prolonged survival. Longitudinal studies with larger cohorts are warranted to further investigate the effectiveness of each modality.

Cardiac effects of adjuvant doxorubicin and radiation therapy in breast cancer patients.

1998 ◽  
Vol 16 (11) ◽  
pp. 3493-3501 ◽  
Author(s):  
C L Shapiro ◽  
P H Hardenbergh ◽  
R Gelman ◽  
D Blanks ◽  
P Hauptman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Cardiac Events ◽  
Female Population ◽  
Cardiac Effects ◽  
Dose Volume ◽  
Increased Risk

PURPOSE To assess the cardiac effects of two different cumulative doses of adjuvant doxorubicin and radiation therapy (RT) in breast cancer patients. PATIENTS AND METHODS Two hundred ninety-nine breast cancer patients were prospectively randomized to receive either five cycles (CA5) or 10 cycles (CA10) of adjuvant treatment with cyclophosphamide (500 mg/ m2) and doxorubicin (45 mg/m2) administered by intravenous bolus every 21 days. One hundred twenty-two of these patients also received RT. Estimates of the cardiac RT dose-volume were retrospectively categorized as low, moderate, or high. The risk of major cardiac events (congestive heart failure, acute myocardial infarction) was assessable in 276 patients (92%), with a median follow-up time of 6.0 years (range, 0.5 to 19.4). RESULTS The estimated risk (95% confidence interval) of cardiac events per 100 patient-years was significantly higher for CA10 than for CA5 [1.7 (1.0 to 2.8) v 0.5 (0.1 to 1.2); P=.02]. The risk of cardiac events in CA5 patients, irrespective of the cardiac RT dose-volume, did not differ significantly from rates of cardiac events predicted for the general female population by the Framingham Heart Study. In CA10 patients, the incidence of cardiac events was significantly increased (relative risk ratio, 3.6; P < .00003) compared with the Framingham population, particularly in groups that also received moderate and high dose-volume cardiac RT. CONCLUSION Conventional-dose adjuvant doxorubicin as delivered in the CA5 regimen by itself, or in combination with locoregional RT, was not associated with a significant increase in the risk of cardiac events. Higher doses of adjuvant doxorubicin (CA10) were associated with a threefold to fourfold increased risk of cardiac events. This appears to be especially true in patients treated with higher dose-volumes of cardiac RT. Larger studies with longer follow-up periods are needed to confirm these results.

scholarly journals Other Primary Malignancies Among Women With Adult-Type Ovarian Granulosa Cell Tumors

2018 ◽  
Vol 28 (8) ◽  
pp. 1529-1534 ◽  
Author(s):  
Saara Bryk ◽  
Eero Pukkala ◽  
Anniina Färkkilä ◽  
Markku Heikinheimo ◽  
Leila Unkila-Kallio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Soft Tissue ◽  
Granulosa Cell ◽  
Uterine Cancer ◽  
Primary Diagnosis ◽  
Breast Cancers ◽  
Breast Cancer Patients ◽  
Adult Type ◽  
Increased Risk ◽  
Shared Risk

ObjectiveThe aim of this study was to determine the incidence of new primary malignancies after adult-type granulosa cell tumor (AGCT) and the incidence of AGCT after breast and uterine cancer using nationwide population-based registry data.MethodsWe used the Finnish Cancer Registry to identify all patients diagnosed with AGCT in 1968 to 2013 (n = 986). The number of subsequent primary malignancies among women with AGCT and the number of AGCTs in women with previous breast or uterine cancer were compared with the expected number of cases and expressed as standardized incidence ratios (SIRs).ResultsThere were 122 cases of subsequent cancers diagnosed at least 6 months after the primary diagnosis of AGCT (SIR, 1.09; 95% confidence interval [CI], 0.91–1.3). In particular, the observed number of cancers of the soft tissue (SIR, 4.13; 95% CI, 1.33–12.8), thyroid (SIR, 3.42; 95% CI, 1.54–7.62), and leukemia (SIR, 2.67; 95% CI, 0.98–5.82) exceeded the number of expected cases. The SIR for breast cancers after AGCT was 1.26 (95% CI, 0.92–1.73), and the SIR for AGCT after breast cancer was 1.59 (95% CI, 1.04–2.29). The risk for subsequent AGCT was more than 2-fold in breast cancer patients younger than 50 years, and over 15 years after primary diagnosis.ConclusionsThere is an increased risk for thyroid and soft tissue cancer as well as leukemia after AGCT, which may be associated with late effects of carcinogenic treatments and possibly shared risk factors. After breast cancer, the risk for AGCT was higher, which may indicate a shared hormonal etiology.

scholarly journals Genetically associated breast cancer. Prevention and treatment

2019 ◽  
pp. 3-9
Author(s):  
А.Д. Зикиряходжаев ◽  
Э.К. Сарибекян ◽  
А.С. Сухотько ◽  
А.В. Трегубова
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Cumulative Risk ◽  
Brca2 Gene ◽  
Contralateral Breast ◽  
Malignant Neoplasms ◽  
Female Population ◽  
Increased Risk ◽  
Incidence And Mortality ◽  
Brca1 Brca2

Рак молочной железы (РМЖ) занимает первое место в структуре онкологической заболеваемости и смертности от злокачественных новообразований среди женского населения Российской Федерации. Согласно последним статистическим данным, отмечается неуклонный рост заболеваемости РМЖ, что требует более тщательного изучения возможных мер профилактики его развития. Одним из современных методов обследования при подозрении на РМЖ является выполнение генетического исследования на наличие мутаций, увеличивающих риски развития заболевания. Так, на сегодняшний день известно большое количество генов, ассоциированных с повышенным риском развития РМЖ, к таким генам относятся: BRCA1, BRCA2, CHEK2, TP53, STK-11 и многие другие. При выявлении той или иной мутации у пациентки повышаются риски развития РМЖ, а если заболевание уже реализовано, то риски развития рака контрлатеральной молочной железы. По данным литературы, кумулятивный риск развития РМЖ у носителей мутации в гене BRCA1 к 80 годам составляет 72%, при этом риск развития рака яичников составляет 44% и 40% риск развития рака контралатеральной молочной железы. Для носителей мутации в гене BRCA2 кумулятивный риск развития РМЖ составляет 69%, риск развития рака яичников составляет 17% и 26% риск развития рака контралатеральной молочной железы. Учитывая значительное повышение рисков развития РМЖ при носительстве мутации в том или ином гене, актуальным, на сегодняшний день, является вопрос о внедрении в широкую практику профилактических операций, которые позволяют значительно снизить риски развития РМЖ. В данном обзоре литературы представлены наиболее актуальные статьи, затрагивающие данную тематику. Breast cancer (BC) occupies the first place in the structure of cancer incidence and mortality from malignant neoplasms among the female population of the Russian Federation. According to the latest statistics, there has been a steady increase in the incidence of breast cancer, which requires a more thorough study of possible measures to prevent its development. One of the modern methods of examination for suspected breast cancer is to carry out a genetic study for mutations that increase the risk of developing breast cancer compared with a group of patients with sporadic breast cancer. So, today a large number of genes are known that are associated with an increased risk of developing breast cancer, these genes include: BRCA1, BRCA2, CHEK2, TP53, STK-11 etc. If one or another mutation is detected in a patient, the risks of developing breast cancer increase, and if the disease has already been realized, then the risks of developing cancer of the contralateral breast. Thus, the cumulative risk of developing breast cancer in carriers of mutations in the BRCA1 gene to 80 years old is 72%, while the risk of developing ovarian cancer is 44% and 40% the risk of developing cancer of the contralateral breast. For carriers of mutations in the BRCA2 gene, the cumulative risk of developing breast cancer is 69%, the risk of developing ovarian cancer is 17% and 26% is the risk of developing cancer of the contralateral breast. Given the significant increase in the risks of developing breast cancer with carriage of a mutation in a particular gene, today, the urgent issue is the introduction of preventive surgery into widespread practice, since it is the implementation of preventive mastectomy that can significantly reduce the risks of developing breast cancer. This literature review presents the most relevant articles affecting this topic.

Treatment-Related Acute Myeloid Leukemia Following Therapy for Acute Myeloid Leukemia.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2777-2777
Author(s):  
I. Conradi ◽  
T. Schulz ◽  
B. Woermann ◽  
G. G. Wulf ◽  
L. Truemper ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Topoisomerase Ii ◽  
Clonal Evolution ◽  
Alkylating Agents ◽  
Primary Diagnosis ◽  
Initial Diagnosis ◽  
Related Characteristic ◽  
Acute Myeloid

Abstract More than 50% of patients (pts.) who relapse from Acute Myeloid Leukemia (AML) have karyotypes different from those seen at primary diagnosis. This phenomenon might mirror clonal evolution or might result from antecedent therapies. In some cases completely different karyotypes might characterize treatment-related AML (t-AML). t-AML is a well recognized complication following treatment of malignancies with a high cure rate, especially primary breast cancer and Hodgkin’s Disease and, according to a recently increasing number of reports, even in Acute Promyelocytic Leukemia. However, as to our knowledge there are no data from larger series concerning therapy-induced AML following chemotherapy for AML also comprising Non-M3-AML. Furthermore we asked if polymorphisms in phase-II-enzymes like Gluthathione S-Transferase (GST) or N-Acetyl-Transferase (NAT) might be risk factors for t-AML. Cytogenetics of 141 (72 male, 69 female) pts. who were presumed to have relapsed from AML on the basis of cytologic criteria were performed. In 99 of them cytogenetic data from initial diagnosis could be made available and were compared to the corresponding results on relapse. Six classes of cytogenetic sequences (initial diagnosis --&gt; relapse) were defined (normal --&gt; normal: 29 pts; normal --&gt; aberrant: 16 pts.; aberrant --&gt; aberrant with identical aberrations: 22 pts.; aberrant --&gt; aberrant with additional anomalies: 19 pts.; aberrant --&gt; aberrant with completely different anomalies: 7pts.; aberrant --&gt; normal: 6 pts.) to characterize the dynamics of genetics from diagnosis to relapse. Among the 7 pts. who developed completely different anomalies from those seen at initial diagnosis 2 had cytogenetic anomalies characteristic for those seen following treatment with alkylating agents, while the aberrations in the remaining pts. fitted neither those typical for alkylating agents nor those for the topoisomerase-II-inhibitor type of treatment related anomalies. Of the 35 pts. in the second and third group together 3 pts. presented chromosomal changes of alkylating agents’ type, 2 of topoisomerase-II-inhibitors’ type, 1 patient a combination of both and in the remaining pts. such aberrations that could not be related to defined groups of chemotherapeutics so far. As far as available data from bone marrow smears, immunophenotyping, Fluorescence-In-Situ-Hybridization and moleculargenetics were used to differentiate clonal evolution from the development of a chemotherapy induced new clone. We conclude that a small proportion (6,93%) of seemingly relapsed AMLs might be treatment related, thus representing new clonal hematologic disorders completely different from the initial disease. Cytogenetic aberrations characteristic of alkylating drugs arose in pts. some of whom never received alkylating agents and at time intervals shorter than those supposed to be characteristic of t-AML following this class of drugs. Perhaps further types of treatment related characteristic anomalies induced by other components of AML-treatment such as Ara C or Thioguanin could be defined soon that so far cannot directly be related to certain drugs. Furthermore in a substantial proportion of pts. (34,65%) it cannot be excluded, that clonal evolution had been modulated by antecedent antileukemic chemotherapy. Preliminary data suggest that at least in t-AML following breast cancer treatment polymorphisms of GST influence the risk of t-AML.

A comparison of platinum-based chemotherapy versus capecitabine-based chemotherapy in the treatment of breast cancer metastasis to the liver.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12595-e12595
Author(s):  
Yimeng Chen ◽  
Hongnan Mo ◽  
Jiayu Wang ◽  
Yiqun Li ◽  
Xiuwen Guan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastasis ◽  
Cancer Metastasis ◽  
Growth Factor Receptor ◽  
Breast Cancer Metastasis ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Platinum Based Chemotherapy ◽  
First Choice ◽  
The Impact

e12595 Background: Liver metastasis have long been known to indicate an unfavourable disease course in breast cancer (BC). A variety of drugs have been used in first choice for anthracycline-resistant and/or taxane-resistant breast cancer. This study aimed to systematically investigate the impact of different treatments. Methods: Between January 2003 and December 2013, we examined the clinical outcome of breast cancer patients with liver metastases from database in China National Cancer Center. 284 patients who received platinum or capecitabine based chemotherapy as first-line treatment were analyzed and followed up until December 2018. Results: Overall, 284 patients (female:280/284 (98.6%); male:4/284 (1.4%)) breast cancer with liver metastasis were available for this analysis. 205/ 284 patients (72.2%) received capecitabine-based chemotherapy including docetaxel/capecitabine (TX) and vinorelbine/capecitabine(NX), while 79/284 patients (27.8%) received platinum-based chemotherapy including docetaxel/ platinum (TP) and vinorelbine/platinum(NP).The median PFS (10.1 vs 8.3 months; P = .329; 95%), and the median overall survival (OS) (35.3 vs 19.8 months; P = .012) in the TX/NX group appeared to be longer compared with those in the NP/TP group, among which NP group seemed to be the poorest. Patients aged ≥50 years who were postmenopausal were more likely to benefit from the TX/NX regimens in terms of OS, however hormone receptor and human epidermal growth factor receptor 2 status did not affect differences in PFS and OS between the TX/NX and TP/NP groups. Conclusions: Capecitabine-based chemotherapy for advanced breast cancer with liver metastasis led to longer OS than platinum-based chemotherapy. These findings should be validated in more prospective cohorts.

Chemokine Receptor CXCR4 Expression in Colorectal Cancer Patients Increases the Risk for Recurrence and for Poor Survival

2005 ◽  
Vol 23 (12) ◽  
pp. 2744-2753 ◽  
Author(s):  
Joseph Kim ◽  
Hiroya Takeuchi ◽  
Stella T. Lam ◽  
Roderick R. Turner ◽  
He-Jing Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastasis ◽  
Cell Lines ◽  
Chemokine Receptor ◽  
Cancer Metastasis ◽  
Cxcr4 Expression ◽  
Signaling Mechanism ◽  
Chemokine Receptor Cxcr4 ◽  
Ajcc Stage ◽  
Increased Risk

Purpose Liver metastasis is the predominant cause of colorectal cancer (CRC) related mortality. Chemokines, soluble factors that orchestrate hematopoetic cell movement, have been implicated in directing cancer metastasis, although their clinical relevance in CRC has not been defined. Our hypothesis was that the chemokine receptor CXCR4 expressed by CRC is a prognostic factor for poor disease outcome. Methods CRC cell lines (n = 6) and tumor specimens (n = 139) from patients with different American Joint Committee on Cancer (AJCC) stages of CRC were assessed. Microarray screening of select specimens and cell lines identified CXCR4 as a prominent chemokine receptor. CXCR4 expression in tumor and benign specimens was assessed by quantitative real-time reverse transcription polymerase chain reaction and correlated with disease recurrence and overall survival. Results High CXCR4 expression in tumor specimens (n = 57) from AJCC stage I/II patients was associated with increased risk for local recurrence and/or distant metastasis (risk ratio, 1.35; 95% CI, 1.09 to 1.68; P = .0065). High CXCR4 expression in primary tumor specimens (n = 35) from AJCC stage IV patients correlated with worse overall median survival (9 months v 23 months; RR, 2.53; 95% CI, 1.19 to 5.40; P = .016). CXCR4 expression was significantly higher in liver metastases (n = 39) compared with primary CRC tumors (n = 100; P < .0001). Conclusion CXCR4, a well-characterized chemokine receptor for T-cells, is differentially expressed in CRC. CXCR4 gene expression in primary CRC demonstrated significant associations with recurrence, survival, and liver metastasis. The CXCR4-CXCL12 signaling mechanism may be clinically relevant for patients with CRC and represents a potential novel target for disease-directed therapy.

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