High lung shunt fraction in colorectal liver tumors is associated with distant metastasis and decreased survival

Amy R. Deipolyi, A. John Iafrate, Andrew X. Zhu, Emel A. Ergul, Suvranu Ganguli, Rahmi Oklu

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose To assess how intratumoral shunting relates to liver metastasis and to clinical outcome.

Materials and Methods Lung shunt fraction (LSF) was calculated from macroaggregated albumin scan after transcatheter injection of radioactive particles in 62 patients with colorectal cancer and liver metastases evaluated for selective internal radiation therapy (SIRT) from May 2007 to August 2012. Assessment was performed of how LSF, liver tumor burden, and systemic chemotherapy relate to survival and the presence of lung metastases. LSF and tumor burden were also assessed in a subset of patients who underwent genetic profiling with SNaPshot analysis.

Results Patients with higher LSF were more likely to have lung metastases and decreased survival, whereas tumor burden was not associated with these outcomes. Patients with genetic mutations had significantly higher LSF than patients with no mutations. Patients who received chemotherapy before SIRT and had low LSF had the longest survival after SIRT.

Conclusions LSF may be a more robust marker of metastasis than tumor size. Increased LSF secondary to vascular shunting within liver metastasis is an indicator of distant lesions and is associated with decreased survival after SIRT. Intratumoral shunting may provide a conduit for circulating tumor cells to access more remote organs, bypassing filtration by liver parenchyma, and may be an important factor in metastasis from colorectal cancer.

Original languageEnglish (US)
Pages (from-to)1604-1608
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume25
Issue number10
DOIs
StatePublished - Oct 1 2014
Externally publishedYes

Fingerprint

Colorectal Neoplasms
Neoplasm Metastasis
Lung
Survival
Liver
Radiotherapy
Tumor Burden
Circulating Neoplastic Cells
Drug Therapy
Mutation
Liver Neoplasms
Tumor Biomarkers
Blood Vessels
Albumins
Injections

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

High lung shunt fraction in colorectal liver tumors is associated with distant metastasis and decreased survival. / Deipolyi, Amy R.; Iafrate, A. John; Zhu, Andrew X.; Ergul, Emel A.; Ganguli, Suvranu; Oklu, Rahmi.

In: Journal of Vascular and Interventional Radiology, Vol. 25, No. 10, 01.10.2014, p. 1604-1608.

Research output: Contribution to journalArticle

Deipolyi, Amy R. ; Iafrate, A. John ; Zhu, Andrew X. ; Ergul, Emel A. ; Ganguli, Suvranu ; Oklu, Rahmi. / High lung shunt fraction in colorectal liver tumors is associated with distant metastasis and decreased survival. In: Journal of Vascular and Interventional Radiology. 2014 ; Vol. 25, No. 10. pp. 1604-1608.
@article{50593adb56f64d95b55f377e8301e362,
title = "High lung shunt fraction in colorectal liver tumors is associated with distant metastasis and decreased survival",
abstract = "Purpose To assess how intratumoral shunting relates to liver metastasis and to clinical outcome.Materials and Methods Lung shunt fraction (LSF) was calculated from macroaggregated albumin scan after transcatheter injection of radioactive particles in 62 patients with colorectal cancer and liver metastases evaluated for selective internal radiation therapy (SIRT) from May 2007 to August 2012. Assessment was performed of how LSF, liver tumor burden, and systemic chemotherapy relate to survival and the presence of lung metastases. LSF and tumor burden were also assessed in a subset of patients who underwent genetic profiling with SNaPshot analysis.Results Patients with higher LSF were more likely to have lung metastases and decreased survival, whereas tumor burden was not associated with these outcomes. Patients with genetic mutations had significantly higher LSF than patients with no mutations. Patients who received chemotherapy before SIRT and had low LSF had the longest survival after SIRT.Conclusions LSF may be a more robust marker of metastasis than tumor size. Increased LSF secondary to vascular shunting within liver metastasis is an indicator of distant lesions and is associated with decreased survival after SIRT. Intratumoral shunting may provide a conduit for circulating tumor cells to access more remote organs, bypassing filtration by liver parenchyma, and may be an important factor in metastasis from colorectal cancer.",
author = "Deipolyi, {Amy R.} and Iafrate, {A. John} and Zhu, {Andrew X.} and Ergul, {Emel A.} and Suvranu Ganguli and Rahmi Oklu",
year = "2014",
month = "10",
day = "1",
doi = "10.1016/j.jvir.2014.06.019",
language = "English (US)",
volume = "25",
pages = "1604--1608",
journal = "Journal of Vascular and Interventional Radiology",
issn = "1051-0443",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - High lung shunt fraction in colorectal liver tumors is associated with distant metastasis and decreased survival

AU - Deipolyi, Amy R.

AU - Iafrate, A. John

AU - Zhu, Andrew X.

AU - Ergul, Emel A.

AU - Ganguli, Suvranu

AU - Oklu, Rahmi

PY - 2014/10/1

Y1 - 2014/10/1

N2 - Purpose To assess how intratumoral shunting relates to liver metastasis and to clinical outcome.Materials and Methods Lung shunt fraction (LSF) was calculated from macroaggregated albumin scan after transcatheter injection of radioactive particles in 62 patients with colorectal cancer and liver metastases evaluated for selective internal radiation therapy (SIRT) from May 2007 to August 2012. Assessment was performed of how LSF, liver tumor burden, and systemic chemotherapy relate to survival and the presence of lung metastases. LSF and tumor burden were also assessed in a subset of patients who underwent genetic profiling with SNaPshot analysis.Results Patients with higher LSF were more likely to have lung metastases and decreased survival, whereas tumor burden was not associated with these outcomes. Patients with genetic mutations had significantly higher LSF than patients with no mutations. Patients who received chemotherapy before SIRT and had low LSF had the longest survival after SIRT.Conclusions LSF may be a more robust marker of metastasis than tumor size. Increased LSF secondary to vascular shunting within liver metastasis is an indicator of distant lesions and is associated with decreased survival after SIRT. Intratumoral shunting may provide a conduit for circulating tumor cells to access more remote organs, bypassing filtration by liver parenchyma, and may be an important factor in metastasis from colorectal cancer.

AB - Purpose To assess how intratumoral shunting relates to liver metastasis and to clinical outcome.Materials and Methods Lung shunt fraction (LSF) was calculated from macroaggregated albumin scan after transcatheter injection of radioactive particles in 62 patients with colorectal cancer and liver metastases evaluated for selective internal radiation therapy (SIRT) from May 2007 to August 2012. Assessment was performed of how LSF, liver tumor burden, and systemic chemotherapy relate to survival and the presence of lung metastases. LSF and tumor burden were also assessed in a subset of patients who underwent genetic profiling with SNaPshot analysis.Results Patients with higher LSF were more likely to have lung metastases and decreased survival, whereas tumor burden was not associated with these outcomes. Patients with genetic mutations had significantly higher LSF than patients with no mutations. Patients who received chemotherapy before SIRT and had low LSF had the longest survival after SIRT.Conclusions LSF may be a more robust marker of metastasis than tumor size. Increased LSF secondary to vascular shunting within liver metastasis is an indicator of distant lesions and is associated with decreased survival after SIRT. Intratumoral shunting may provide a conduit for circulating tumor cells to access more remote organs, bypassing filtration by liver parenchyma, and may be an important factor in metastasis from colorectal cancer.

UR - http://www.scopus.com/inward/record.url?scp=84908162847&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908162847&partnerID=8YFLogxK

U2 - 10.1016/j.jvir.2014.06.019

DO - 10.1016/j.jvir.2014.06.019

M3 - Article

C2 - 25086965

AN - SCOPUS:84908162847

VL - 25

SP - 1604

EP - 1608

JO - Journal of Vascular and Interventional Radiology

JF - Journal of Vascular and Interventional Radiology

SN - 1051-0443

IS - 10

ER -