Spread of a disease to distant sites. Unless stated otherwise, it describes cancer that has spread to distant sites to form secondary tumours, but it can also refer to infections, e.g. endocarditis and osteomyelitis.
It is a feature of malignant tumours. Strictly speaking, it does not include spread of cancer by local invasion. The alterations in the cell machinery that makes cells metastatic are complex. Properties required are identical to that required for cancer to develop, but also requires survival of the cell during transit, change in cell adherence and the ability to breach and move through traditional tissue barriers (e.g. by degradation of extra-cellular matrix), implant at the final destination and recruit a blood supply.
Different tumour types have particular predilections for certain sites.
- Iatrogenic, e.g. along biopsy tract in sarcomas.
- There is evidence that micrometastasis may explain early relapse.
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- ↑ Hanahan D, Weinberg RA. The hallmarks of cancer. Cell 2000;100:57-70.
- ↑ Steeg PS. Tumor metastasis: mechanistic insights and clinical challenges. Nature medicine 2006;12:895-904. (Direct link – subscription may be required.)
- ↑ Rothwell PM, Wilson M, Price JF, Belch JF, Meade TW, Mehta Z. Effect of daily aspirin on risk of cancer metastasis: a study of incident cancers during randomised controlled trials. Lancet. 2012 Mar 20.(Epub ahead of print) (Link to article – subscription may be required.)
- ↑ Algra AM, Rothwell PM. Effects of regular aspirin on long-term cancer incidence and metastasis: a systematic comparison of evidence from observational studies versus randomised trials. The lancet oncology. 2012 Mar 20.(Epub ahead of print) (Link to article – subscription may be required.)