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Author Notes:

Corresponding author: David Q. Wan david.q.wan@uth.tmc.edu

DQW designed the concept of this study and participated in manuscript writing.

ESR participated in its design, collected the data and drafted the manuscript.

DTZ participated in the study design, collected the data, and revised the manuscript.

BJB, UAJ, and IWG provided the study material, gave administrative support, and revised the manuscript.

All authors read and approved the final manuscript.

The authors declare that they have no competing interests.


Research Funding:

This manuscript was edited by Tegra Rosera, MA, MS, and Maureen Goode, PhD, ELS, of The University of Texas Health Science Center at Houston Center for Clinical and Translational Sciences (supported by National Institutes of Health Clinical and Translational Science Award UL1 RR024148).

Does colon cancer ever metastasize to bone first? a temporal analysis of colorectal cancer progression


Journal Title:

BMC Cancer


Volume 9, Number 274


Type of Work:

Article | Final Publisher PDF


Background It is well recognized that colorectal cancer does not frequently metastasize to bone. The aim of this retrospective study was to establish whether colorectal cancer ever bypasses other organs and metastasizes directly to bone and whether the presence of lung lesions is superior to liver as a better predictor of the likelihood and timing of bone metastasis. Methods We performed a retrospective analysis on patients with a clinical diagnosis of colon cancer referred for staging using whole-body 18F-FDG PET and CT or PET/CT. We combined PET and CT reports from 252 individuals with information concerning patient history, other imaging modalities, and treatments to analyze disease progression. Results No patient had isolated osseous metastasis at the time of diagnosis, and none developed isolated bone metastasis without other organ involvement during our survey period. It took significantly longer for colorectal cancer patients to develop metastasis to the lungs (23.3 months) or to bone (21.2 months) than to the liver (9.8 months). Conclusion: Metastasis only to bone without other organ involvement in colorectal cancer patients is extremely rare, perhaps more rare than we previously thought. Our findings suggest that resistant metastasis to the lungs predicts potential disease progression to bone in the colorectal cancer population better than liver metastasis does.

Copyright information:

©2009 Roth et al; licensee BioMed Central Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 2.0 Generic License (http://creativecommons.org/licenses/by/2.0/).

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