Patients With Multifocal Cancer: Evidence for Intraluminal Spread of Tumor
Douglas K. Rex, MD, MASGE, reviewing Simmer F, et al. Gastroenterology 2020 Dec 11.
In various series, 2% to 7% of patients with colorectal cancer (CRC) have either synchronous or metachronous second cancer. Second CRCs have generally been considered to be independent primary cancers. In a study of 24 patients, each with two diagnoses of CRC, DNA analysis indicated that one tumor was a clone of the other in 8 patients.
Although the mechanism of spread is unclear, the authors believe it might be associated with intraluminal spread, perhaps to sites of injury (eg, diverticulitis or iatrogenic injury).
COMMENTA previous study found evidence of metastasis from colorectal cancer to biopsy or polypectomy sites, suggesting that biopsy of the tumor should be performed as the final step in a colonoscopy procedure when colon cancer is discovered. The current study provides additional evidence that intraluminal spread is a rare but real phenomenon.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Simmer F, van der Linden RLA, Ligtenberg MJI, et al. Multifocal colorectal cancer – Do intraluminal metastases occur? Gastroenterology 2020 Dec 11. (Epub ahead of print) (https://doi.org/10.1053/j.gastro.2020.12.010)
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