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. 2023 Jul 8;129(4):672–682. doi: 10.1038/s41416-023-02338-3

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© The Author(s) 2023

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 4 — a Conceptual figures depicting two distinctive metastatic progression patterns, branched and diaspora. Clinical course and phylogenetic tree (by MEDICC2) of a representative case of (b) branched progression (GCM04) and (c) diaspora progression (GCM10). d, e Heatmap of pairwise Jaccard indices, representing genomic similarity between tumors from an individual, in each representative case of branched (GCM04) and diaspora (GCM10) progression. f Statistical comparison of the average Jaccard index between patients with branched versus diaspora progression. Diaspora progression showed a lower Jaccard index, implying more genetic inter-tumoral heterogeneity when compared to branched progression (**; p < 0.005). Kaplan–Meier’s curves for overall survival (OS) based on (g) metastatic migration patterns and migration patterns with the molecular subtypes of (h) primary tumor and (i) metastatic tumors. The diaspora progression was related to poor prognosis when compared to branched progression (P = 0.0031). When considering the molecular subtypes of primary or metastatic tumors together, both the migration pattern and subtype of the metastatic tumors were found to be related to the patients’ survival (p = 0.0017, i). P primary tumor, LN lymph node, Lu lung metastasis, R recurrence, A alive, Li liver metastasis, E expired.