Intestinal Research

Review

Biology and preclinical models of colorectal cancer metastasis: Yoojeong Seo, Jinho Jang, Jae-Il Park; Received December 9, 2025 Accepted January 5, 2026 Published online March 26, 2026; DOI: https://doi.org/10.5217/ir.2025.00315 [Epub ahead of print]

Abstract PDF PubReader ePub: Metastatic colorectal cancer (mCRC) is the principal cause of CRC-related mortality, yet the biology of mCRC remains only partly understood and challenging to interrogate experimentally. Despite recent progress in mapping recurrent genetic and epigenetic alterations and treatment responses of mCRC, these efforts provide limited insight into how heterogeneous primary tumors breach tissue barriers, survive in circulation, and colonize distant organs. In this review, we summarize current experimental systems for studying mCRC, including genetically engineered mouse models, carcinogen-induced and transplant models, and patient-derived organoid and xenograft platforms, and discuss how each captures or fails to capture key steps of the metastatic cascade and organ-specific microenvironments. We highlight practical obstacles to longitudinal sampling and quantitative readouts of metastatic burden, as well as conceptual gaps in modeling immune and stromal influences. Finally, we outline how emerging approaches, including single-cell and spatial transcriptomics, and advances in longitudinal tracking of metastatic burden could be combined into an integrated framework that more faithfully links mechanistic insight to clinical behavior and ultimately to metastasis-specific therapies.

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Original Article

Colorectal neoplasia

Factors associated with the survival of colorectal cancer in Mexico: Carlos Quezada-Gutiérrez, María Teresa Álvarez-Bañuelos, Jaime Morales-Romero, Clara Luz Sampieri, Raúl Enrique Guzmán-García, Evangelina Montes-Villaseñor; Intest Res 2020;18(3):315-324. Published online May 19, 2020; DOI: https://doi.org/10.5217/ir.2019.09179

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Background/Aims
Colorectal cancer (CRC) is a public health problem. In Mexico, there have been no recent studies conducted on survival in terms of this pathology or on the influence of prognostic factors. The study aims to determine the probability of survival in patients with CRC presence of low levels of schooling and a rural population, adjusted for clinical stage and type of treatment.
Methods
A retrospective study was conducted in a cohort of 305 patients with CRC treated at State Cancer Center, located in Veracruz-Mexico; the follow-up period of 60 months (2012–2016). The survival probability was calculated using the Kaplan-Meier estimator and the log-rank test with 95% confidence intervals (CIs). Prognostic factors were determined using hazard ratio (HR) multivariate Cox regression analysis.
Results
Overall survival was 40% at 60 months. Subjects in the age group ≥ 65 years had a low survival rate of 28% (P= 0.026) and an advanced clinical stage of 22% (P< 0.001). Of the patients with bone metastasis, none survived longer than 5 years (P= 0.008). With respect to the unfavorable prognostic factors identified in the multivariate analysis, a decreased level of schooling was associated with an HR of 7.6 (95% CI, 1.1–54.7), advanced clinical stage was associated with an HR of 2.1 (95% CI, 1.2–4.0), and the presence of metastasis had an HR of 1.8 (95% CI, 1.1–2.9).
Conclusions
Poor prognostic factors include an advanced clinical stage, the presence of metastasis and a low level of schooling. These findings confirm the importance of screening for early diagnosis, diminishing the barriers to accessing treatment and prospectively monitoring the population.

Citations

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Colorectal cancer survival in Mexico: Leveraging a national health insurance database
Susana Lozano-Esparza, Hugo Rodrigo Sánchez-Blas, Fidel David Huitzil-Meléndez, Mónica Isabel Meneses-Medina, Katherine Van Loon, Michael B. Potter, Alejandro Mohar, Martin Lajous
Cancer Epidemiology.2025; 94: 102698. CrossRef
Colorectal cancer survival disparities in the five regions of Georgia
Meng-Han Tsai, Daramola N. Cabral, Caitlyn Grunert, Justin X. Moore, Hong Qin
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Case Report

Natural Course of an Untreated Metastatic Perirectal Lymph Node After the Endoscopic Resection of a Rectal Neuroendocrine Tumor: Sang Hyung Kim, Dong-Hoon Yang, Jung Su Lee, Soyoung Park, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Chan Wook Kim, Jihun Kim; Intest Res 2015;13(2):175-179. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.175

Abstract PDF PubReader

Lymph node metastasis is rare in small (i.e., <10 mm) rectal neuroendocrine tumors (NETs). In addition to tumor size, pathological features such as the mitotic or Ki-67 proliferation index are associated with lymph node metastasis in rectal NETs. We recently treated a patient who underwent endoscopic treatment of a small, grade 1 rectal NET that recurred in the form of perirectal lymph node metastasis 7 years later. A 7-mm-sized perirectal lymph node was noted at the time of the initial endoscopic treatment. The same lymph node was found to be slightly enlarged on follow-up and finally confirmed as a metastatic NET. Therefore, the perirectal lymph node metastasis might have been present at the time of the initial diagnosis. However, the growth rate of the lymph node was extremely low, and it took 7 years to increase in size from 7 to 10 mm. NETs with low Ki-67 proliferation index and without mitotic activity may grow extremely slowly even if they are metastatic.

Citations

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Long-Term Outcomes after the Complete Resection of Rectal Neuroendocrine Tumors: A Multicenter Cohort Study
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World Journal of Gastroenterology.2025;[Epub] CrossRef
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International Journal of Gastrointestinal Intervention.2023; 12(3): 105. CrossRef
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Ho Suk Kang, Mi Jung Kwon, Tae-Hwan Kim, Junhee Han, Young-Su Ju
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9,772 View
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