Clinical patterns of metastasis

Stanley P. L. Leong1 , Blake Cady2, David M. Jablons1, Julio Garcia-Aguilar1, Douglas Reintgen3, J. Jakub3, S. Pendas3, L. Duhaime3, R. Cassell3, M. Gardner3, R. Giuliano3, V. Archie3, D. Calvin3, L. Mensha3, S. Shivers3, C. Cox4, J. A. Werner5, Y. Kitagawa6 and M. Kitajima6

(1) Department of Surgery, University of California, and UCSF Comprehensive Cancer Center, San Francisco, CA, USA
(2) Rhode Island Hospital, Brown University, Providence, RI, USA
(3) Department of Surgical Oncology, Lakeland Regional Cancer Center, Lakeland, FL, USA
(4) H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
(5) Department of Otolaryngology, Head and Neck Surgery, Philipps University of Marburg, Deutschhausstr 3, 35037 Marburg, Germany
(6) Department of Surgery, Keio University, Tokyo, Japan


Abstract In human solid cancer, lymph node status is the most important indicator for clinical outcome. Recent developments in the sentinel lymph node concept and technology have resulted in a more precise way of examining micrometastasis in the sentinel lymph node and the role of lymphovascular system in the facilitation of cancer metastasis.
Different patens of metastasis are described with respect to different types of solid cancer. Expect perhaps for papillary carcinoma and sarcoma, the overwhelming evidence is that solid cancer progresses in an orderly progression from the primary site to the regional lymph node or the sentinel lymph node in the majority of cases with subsequent dissemination to the systemic sites. The basic mechanisms of cancer metastasis through the lymphovascular system form the basis of rational therapy against cancer. Beyond the clinical patterns of metastasis, it is imperative to understand the biology of metastasis and to characterize patterns of metastasis perhaps due to heterogeneous clones based on their molecular signatures.
Keywords Cancer metastasis - Sentinel lymph nodes - Lymphovascular system

Presented as Session IV of the First International Symposium on Cancer Metastasis and the Lymphovascular System. April 28–30, 2005, San Francisco, CA; Chaired by Stanley P. L. Leong.