Hepatic metastasis of gastroenterological cancer: its tumor biology and oncological surgery.
Tumor angiogenesis and ability of basement membrane invasion for invasion of cancer cells into the tumor vessels and for circulating in the blood stream for hepatic metastasis are required. The molecular detection of cancer cells in the circulatory system strongly indicates the possibility of hepatic metastasis of a gastroenterological cancer. As an effect of the general anesthesia or the surgical procedure, a large amount of cancer cells in the tumor vessels may easily enter into the circulatory system at once from the primary tumor beds. Oncological surgeons should understand that the operation is not only the best treatment for gastroenterological cancer but also the crucial event of hepatic metastasis for cancer cells. Although further investigations are required to determine the relationship between circulating cancer cells and hepatic metastasis, at present, the most important issue to be addressed is the development of new strategies for the prevention of hepatic metastasis following the tumor resection in gastroenterological cancer.
Takao
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S
First Department of Surgery, Kagoshima University School of Medicine. sonshin@med6.kufm.kagoshima-u.ac.jp
Natsugoe
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S
Aikou
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T
D001485:Basement Membrane / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005770:Gastrointestinal Neoplasms / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000556:secondary*; D020782:Matrix Metalloproteinases / Q000032:analysis; D009361:Neoplasm Invasiveness; D009360:Neoplastic Cells, Circulating; D009389:Neovascularization, Pathologic; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013939:Thymidine Phosphorylase / Q000032:analysis; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D013939:Thymidine Phosphorylase; D020782:Matrix Metalloproteinases