Unique patterns of metastases in common and rare types of malignancy

Stanley P L Leong, Eric K. Nakakura, Raphael Pollock, Michael A. Choti, Donald L. Morton, W. David Henner, Anita Lal, Raji Pillai, Orlo H. Clark, Blake Cady

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

This review on the unique patterns of metastases by common and rare types of cancer addresses regional lymphatic metastases but also demonstrates general principles by consideration of vital organ metastases. These general features of successfully treated metastases are relationships to basic biological behavior as illustrated by disease-free interval, organ-specific behavior, oligo-metastatic presentation, genetic control of the metastatic pattern, careful selection of patients for surgical resection, and the necessity of complete resection of the few patients eligible for long-term survival after resection of vital organ metastasis. Lymph node metastases, while illustrating these general features, are not related to overall survival because lymph node metastases themselves do not destroy a vital organ function, and therefore have no causal relationship to overall survival. When a cancer cell spreads to a regional lymph node, does it also simultaneously spread to the systemic site or sites? Alternatively, does the cancer spread to the regional lymph node first and then it subsequently spreads to the distant site(s) after an incubation period of growth in the lymph node? Of course, if the cancer is in its incubation stage in the lymph node, then removal of the lymph node in the majority of cases with cancer cells may be curative. The data from the sentinel lymph node era, particularly in melanoma and breast cancer, is consistent with the spectrum theory of cancer progression to the sentinel lymph node in the majority of cases prior to distant metastasis. Perhaps, different subsets of cancer may be better defined with relevant biomarkers so that mechanisms of metastasis can be more accurately defined on a molecular and genomic level.

Original languageEnglish (US)
Pages (from-to)607-614
Number of pages8
JournalJournal of Surgical Oncology
Volume103
Issue number6
DOIs
StatePublished - May 1 2011

Fingerprint

Neoplasm Metastasis
Lymph Nodes
Neoplasms
Survival
Lymphatic Metastasis
Patient Selection
Melanoma
Biomarkers
Breast Neoplasms
Growth
Sentinel Lymph Node

Keywords

  • cancer
  • metastases
  • patterns

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Leong, S. P. L., Nakakura, E. K., Pollock, R., Choti, M. A., Morton, D. L., Henner, W. D., ... Cady, B. (2011). Unique patterns of metastases in common and rare types of malignancy. Journal of Surgical Oncology, 103(6), 607-614. https://doi.org/10.1002/jso.21841

Unique patterns of metastases in common and rare types of malignancy. / Leong, Stanley P L; Nakakura, Eric K.; Pollock, Raphael; Choti, Michael A.; Morton, Donald L.; Henner, W. David; Lal, Anita; Pillai, Raji; Clark, Orlo H.; Cady, Blake.

In: Journal of Surgical Oncology, Vol. 103, No. 6, 01.05.2011, p. 607-614.

Research output: Contribution to journalArticle

Leong, SPL, Nakakura, EK, Pollock, R, Choti, MA, Morton, DL, Henner, WD, Lal, A, Pillai, R, Clark, OH & Cady, B 2011, 'Unique patterns of metastases in common and rare types of malignancy', Journal of Surgical Oncology, vol. 103, no. 6, pp. 607-614. https://doi.org/10.1002/jso.21841
Leong SPL, Nakakura EK, Pollock R, Choti MA, Morton DL, Henner WD et al. Unique patterns of metastases in common and rare types of malignancy. Journal of Surgical Oncology. 2011 May 1;103(6):607-614. https://doi.org/10.1002/jso.21841
Leong, Stanley P L ; Nakakura, Eric K. ; Pollock, Raphael ; Choti, Michael A. ; Morton, Donald L. ; Henner, W. David ; Lal, Anita ; Pillai, Raji ; Clark, Orlo H. ; Cady, Blake. / Unique patterns of metastases in common and rare types of malignancy. In: Journal of Surgical Oncology. 2011 ; Vol. 103, No. 6. pp. 607-614.
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