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Abstract 4532: Adrenal metastases in lung cancer: Clinical implications of a mathematical model

Abstract 4532: Adrenal metastases in lung cancer: Clinical implications of a mathematical model

Authors :
Lyudmila Bazhenova
Lori Marx-Rubiner
Jorge Nieva
Peter Kuhn
Jeremy M. Mason
AnneMarie Ciccarella
Kelly Bethel
Paul K. Newton
Source :
Cancer Research. 77:4532-4532
Publication Year :
2017
Publisher :
American Association for Cancer Research (AACR), 2017.

Abstract

Adrenal gland metastases are common in lung cancer. It is well recognized that aggressive treatment of solitary adrenal metastases leads to improved outcomes but the exact nature of adrenal deposits is not well understood. Controversy exists as to the routing of cancer cells to the adrenal gland with some believing that this transmission is lymphatic, in contrast to the more generally accepted theory of hematogenous spread. Using an autopsy dataset of 3827 untreated cancer patients, we use the metastatic distribution of common primary cancer types to create Markov models of progression. The anatomical sites of spread in the body represent states in the model, while the transition probability between states represents the probability of metastatic spread from one site to another. We then use the Markov models to run Monte Carlo simulations of random walkers representing circulating tumor cells traveling within the body to simulate metastatic spread. We calculate mean first passage times (MFPT) to each site as a representative of time to metastasis formation. Analysis of 6 common cancer types (bladder [n=120 autopsies; 289 metastases], breast [n=432; 2235], colorectal [n=161; 420], lung [n=560; 859], ovarian [n=418; 806], and prostate [n=62; 212]) from the dataset showed distinct metastatic distributions across the populations. MFPT calculations to anatomical sites in the 6 analyzed primary cancer types indicated model progression times to the adrenal gland similar to the regional and distal lymph nodes in only lung cancer. The times associated with adrenal gland in the other primary cancers were similar to other metastatic sites of hematogenous spread. The Markov models created strongly support the lymphatic theory for metastatic spread to the adrenal glands. After performing a literature review to look for the biological plausibility of the simulated results, we believe evidence supports this theory and validates the models. This could explain improved survival for patients in whom solitary adrenal metastases are managed aggressively with surgical or radiation modalities. In order to further validate this theory, we are calling for clinical trials prospectively testing this hypothesis. Citation Format: Jeremy M. Mason, AnneMarie Ciccarella, Lori Marx-Rubiner, Lyudmila Bazhenova, Paul K. Newton, Kelly Bethel, Jorge J. Nieva, Peter Kuhn. Adrenal metastases in lung cancer: Clinical implications of a mathematical model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4532. doi:10.1158/1538-7445.AM2017-4532

Details

ISSN :
15387445 and 00085472
Volume :
77
Database :
OpenAIRE
Journal :
Cancer Research
Accession number :
edsair.doi...........ae53c1c883a9d9f6c87e37078347b7bc
Full Text :
https://doi.org/10.1158/1538-7445.am2017-4532