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Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life.

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Nature medicine 📖 저널 OA 65% 2022: 1/1 OA 2024: 2/4 OA 2025: 17/23 OA 2026: 19/30 OA 2022~2026 2025 Vol.31(12) p. 4140-4149
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Newcomer K, Bifolco A, Reeves S, Pontecorvi G, Asawa S, Sznurkowska MK

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End-of-life events related to carcinoma lethality are poorly characterized.

🔬 핵심 임상 통계 (초록에서 자동 추출 — 원문 검증 권장)
  • p-value P < 0.0001
  • 연구 설계 case-control

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APA Newcomer K, Bifolco A, et al. (2025). Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life.. Nature medicine, 31(12), 4140-4149. https://doi.org/10.1038/s41591-025-03966-3
MLA Newcomer K, et al.. "Macrovascular tumor infiltration and circulating tumor cell cluster dynamics in patients with cancer approaching the end of life.." Nature medicine, vol. 31, no. 12, 2025, pp. 4140-4149.
PMID 41102560 ↗

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.

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