The Road to Dissemination: The Concept of Oligometastases and the Barriers for Widespread Disease

Cancers

Mohammad Krayem¹  Jennifer Dhont²  Hamza AlGhamdi³  Dirk Van Gestel³  Pauline De Bruyn³  Robbe Van den Begin³  Benedikt Engels⁴ 

[1] Laboratory of Clinical and Experimental Oncology (LOCE), Jules Bordet Institute, Université Libre de Bruxelles, 1070 Brussels, Belgium;Medical Physics Department, Jules Bordet Institute, Université Libre de Bruxelles, 1070 Brussels, Belgium;Radiotherapy Department, Jules Bordet Institute, Université Libre de Bruxelles, 1070 Brussels, Belgium;Radiotherapy Department, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1050 Brussels, Belgium;

关键词: oligometastasis;    metastasis;    stereotactic radiotherapy;    organ tropism;    cancer biology;   

DOI  :  10.3390/cancers14082046

来源: DOAJ

【 摘 要 】

Over the last years, the oligometastatic disease state has gained more and more interest, and randomized trials are now suggesting an added value of stereotactic radiotherapy on all macroscopic disease in oligometastatic patients; but what barriers could impede widespread disease in some patients? In this review, we first discuss the concept of oligometastatic disease and some examples of clinical evidence. We then explore the route to dissemination: the hurdles a tumoral clone has to overtake before it can produce efficient and widespread dissemination. The spectrum theory argues that the range of metastatic patterns encountered in the clinic is the consequence of gradually obtained metastatic abilities of the tumor cells. Tumor clones can obtain these capabilities by Darwinian evolution, hence early in their genetic progression tumors might produce only a limited number of metastases. We illustrate selective dissemination by discussing organ tropism, the preference of different cancer (sub)types to metastasize to certain organs. Finally we discuss biomarkers that may help to distinguish the oligometastatic state.

【 授权许可】

Unknown