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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.

Original publication

DOI

10.1038/s41588-019-0551-3

Type

Journal article

Journal

Nature genetics

Publication Date

06/01/2020

Volume

52

Pages

74 - 83

Addresses

MRC Cancer Unit, University of Cambridge, Cambridge, UK.