Genomic evidence supports a clonal diaspora model for metastases of esophageal adenocarcinoma

Nat Genet. 2020 Jan;52(1):74-83. doi: 10.1038/s41588-019-0551-3. Epub 2020 Jan 6.

Abstract

The poor outcomes in esophageal adenocarcinoma (EAC) prompted us to interrogate the pattern and timing of metastatic spread. Whole-genome sequencing and phylogenetic analysis of 388 samples across 18 individuals with EAC showed, in 90% of patients, that multiple subclones from the primary tumor spread very rapidly from the primary site to form multiple metastases, including lymph nodes and distant tissues-a mode of dissemination that we term 'clonal diaspora'. Metastatic subclones at autopsy were present in tissue and blood samples from earlier time points. These findings have implications for our understanding and clinical evaluation of EAC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / genetics
  • Adenocarcinoma / secondary*
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Clonal Evolution*
  • Esophageal Neoplasms / genetics
  • Esophageal Neoplasms / pathology*
  • Esophageal Neoplasms / secondary
  • Genomics / methods*
  • Humans
  • Male
  • Middle Aged
  • Models, Statistical*
  • Phylogeny
  • Whole Genome Sequencing
  • Young Adult

Supplementary concepts

  • Adenocarcinoma Of Esophagus