Zhao, Li, Li, Wang, Zhao, Wu, Sun, Lin, Plum, Damanakis, Gebauer, Zhou, Zhang, Schlösser, Jauch, Nelson, Bruns (2019) Tumor biology and multidisciplinary strategies of oligometastasis in gastrointestinal cancers Seminars in cancer biology ()


More than 70% of gastrointestinal (GI) cancers are diagnosed with metastases, leading to poor prognosis. For some cancer patients with limited sites of metastatic tumors, the term oligometastatic disease (OMD) has been coined as opposed to systemic polymetastasis (PMD) disease. Stephan Paget first described an organ-specific pattern of metastasis in 1889, now known as the "seed and soil" theory where distinct cancer types are found to metastasize to different tumor-specific sites. Our understanding of the biology of tumor metastasis and specifically the molecular mechanisms driving their formation are still limited, in particular, as it relates to the genesis of oligometastasis. In the following review, we discuss recent advances in general understanding of this metastatic behavior including the role of specific signaling pathways, various molecular features and biomarkers, as well as the interaction of carcinoma cells with their tissue microenvironments (both primary and metastatic niches). The unique features that underlie OMD provide potential targets for localized therapy. As it relates to clinical practice, OMD is emerging as treatable with surgical resection and/or other local therapy options. Strategies currently being applied in the clinical management of OMD will be discussed including surgical, radiation-based therapy, ablation procedures, and the results of emerging clinical trials involving immunotherapy. Copyright © 2019. Published by Elsevier Ltd.

超过70%的胃肠道(GI)癌症被诊断为转移,导致预后不良。对于一些转移性肿瘤部位有限的癌症患者,术语寡转移性疾病(OMD)与全身性多发性转移(PMD)疾病相反。 Stephan Paget首次描述了1889年器官特异性转移模式,现在被称为“种子和土壤”理论,其中发现不同的癌症类型转移到不同的肿瘤特异性位点。我们对肿瘤转移生物学的理解,特别是驱动其形成的分子机制仍然有限,特别是因为它涉及寡转移的发生。在下面的综述中,我们讨论了对这种转移行为的一般理解的最新进展,包括特定信号传导途径的作用,各种分子特征和生物标志物,以及癌细胞与其组织微环境(原发性和转移性壁龛)的相互作用。 OMD的独特功能为局部治疗提供了潜在的目标。由于涉及临床实践,OMD正在出现,可通过手术切除和/或其他局部治疗选择来治疗。将讨论目前在OMD临床管理中应用的策略,包括手术,基于放射的治疗,消融程序以及涉及免疫疗法的新兴临床试验的结果。版权所有©2019。由Elsevier Ltd.出版