Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life
Year: 2025
Type: article
Study design: Observational Study
Abstract: End-of-life events related to carcinoma lethality are poorly characterized. Herein we conducted an observational, prospective, case-control study enrolling 21 patients with solid tumors and 10 patients without known malignancy, complemented by a retrospective validation cohort of 1,250 patients with cancer. In our prospective cohort, we observed spikes in circulating tumor cell (CTC) counts, particularly clusters, immediately before death (P < 0.0001), as well as pathological evidence of macrovascular infiltration and large-vessel occlusion obtained through rapid autopsy. In the validation cohort, radiological evidence of macrovascular infiltration emerged as the strongest predictor of poor survival-independent of metastasis-in treatment-homogeneous patients with colorectal, lung, ovarian, hepatocellular or pancreatic cancer (hazard ratios = 4.0-22.4). Collectively, these findings suggest that macrovascular infiltration and spikes in CTC clusters with consequent vascular failure could be pivotal end-of-life events associated with cancer lethality, providing a rationale for future trials aimed at curbing infiltration into large vessels.
DOI: 10.5167/uzh-284554
Authors: Newcomer, Kelley, Bifolco, Alessandro, Reeves, Sarah, Pontecorvi, Giada, Asawa, Simran, Sznurkowska, Magdalena K, Nüesch, Manuel, Ozimski, Lauren L, Bolm, Louisa, Sieren, Malte Maria, Müller, Lukas, Chi, Zhikai, Gasper, William, Wachsmann, Megan B, Moore, William, Zheng, Xue, Fokkema, Angelique, Ring, Alexander, Nguyen-Sträuli, Bich Doan, Budinjas, Selina, Ten Winkel, Meike, Färber, Benedikt, Zaki, Abbas, Fatimah, Nafeesah, Crecca, Elena, Karalis, John D, Chandra, Raghav, Prince, Hillary, Goff, Kristina L, Choi, Sung-Hee, et al
Language: English
Topic: Cancer Cells and Metastasis
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7127665135
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