Chapter 25 Introduction to Oncologic Surgery for the General Surgeon

Question 1

What are the four steps involved with metastasis

Answer 1

1. Tumor cell first must leave the primary disease site by invading past the basement membrane and going in between endothelial cells to reach a capillary bed*
2. Intravasation - entry of tumor cells into a vascular or lymphatic vessel
3. Extravasates from vessel and implants in a distant site
4. Angiogenesis

Question 2

What are MMPs role in metastasis

Answer 2

Matrix metalloproteinases are crucial in aiding in the degradation of extracellular matrix during the first step of metastasis

Question 3

Describe the importance of angiogenesis in metastasis

Answer 3

Ability of a cell to proliferate in its new environment depends on its ability to develop a new blood supply (angiogenesis)
Angiogenesis is cruciate to the survival and proliferative ability of a metastatic cell
Progressive hypoxia stimulates angiogenesis