title: Clinical patterns of metastasis.
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 patterns 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.
authors.affiliation: Department of Surgery, University of California, and UCSF Comprehensive Cancer Center, San Francisco, CA, USA. leongs@surgery.ucsf.edu
authors.forename: Stanley P L
authors.initials: SP
authors.lastname: Leong
authors.forename: Blake
authors.initials: B
authors.lastname: Cady
authors.forename: David M
authors.initials: DM
authors.lastname: Jablons
authors.forename: Julio
authors.initials: J
authors.lastname: Garcia-Aguilar
authors.forename: Douglas
authors.initials: D
authors.lastname: Reintgen
authors.forename: J
authors.initials: J
authors.lastname: Jakub
authors.forename: S
authors.initials: S
authors.lastname: Pendas
authors.forename: L
authors.initials: L
authors.lastname: Duhaime
authors.forename: R
authors.initials: R
authors.lastname: Cassell
authors.forename: M
authors.initials: M
authors.lastname: Gardner
authors.forename: R
authors.initials: R
authors.lastname: Giuliano
authors.forename: V
authors.initials: V
authors.lastname: Archie
authors.forename: D
authors.initials: D
authors.lastname: Calvin
authors.forename: L
authors.initials: L
authors.lastname: Mensha
authors.forename: S
authors.initials: S
authors.lastname: Shivers
authors.forename: C
authors.initials: C
authors.lastname: Cox
authors.forename: J A
authors.initials: JA
authors.lastname: Werner
authors.forename: Y
authors.initials: Y
authors.lastname: Kitagawa
authors.forename: M
authors.initials: M
authors.lastname: Kitajima
mesh_terms: D000818:Animals; D001943:Breast Neoplasms / Q000473:pathology; D002291:Carcinoma, Papillary / Q000473:pathology / Q000556:secondary; D005770:Gastrointestinal Neoplasms / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000473:pathology / Q000556:secondary; D009362:Neoplasm Metastasis; D012509:Sarcoma / Q000473:pathology / Q000556:secondary; D021701:Sentinel Lymph Node Biopsy; D013964:Thyroid Neoplasms / Q000473:pathology