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class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Pathophysiology</span> </div> </a> <button aria-controls="toc-Pathophysiology-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Pathophysiology subsection</span> </button> <ul id="toc-Pathophysiology-sublist" class="vector-toc-list"> <li id="toc-Factors_involved" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Factors_involved"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Factors involved</span> </div> </a> <ul id="toc-Factors_involved-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Routes" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Routes"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Routes</span> </div> </a> <ul id="toc-Routes-sublist" class="vector-toc-list"> <li id="toc-Transcoelomic" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Transcoelomic"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.1</span> <span>Transcoelomic</span> </div> </a> <ul id="toc-Transcoelomic-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Lymphatic_spread" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Lymphatic_spread"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.2</span> <span>Lymphatic spread</span> </div> </a> <ul id="toc-Lymphatic_spread-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hematogenous_spread" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Hematogenous_spread"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.3</span> <span>Hematogenous spread</span> </div> </a> <ul id="toc-Hematogenous_spread-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Canalicular_spread" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Canalicular_spread"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2.4</span> <span>Canalicular spread</span> </div> </a> <ul id="toc-Canalicular_spread-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Organ-specific_targets" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Organ-specific_targets"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.3</span> <span>Organ-specific targets</span> </div> </a> <ul id="toc-Organ-specific_targets-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Metastasis_and_primary_cancer" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Metastasis_and_primary_cancer"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.4</span> <span>Metastasis and primary cancer</span> </div> </a> <ul id="toc-Metastasis_and_primary_cancer-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Diagnosis" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Diagnosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Diagnosis</span> </div> </a> <ul id="toc-Diagnosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Management" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Management"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Management</span> </div> </a> <ul id="toc-Management-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Research</span> </div> </a> <ul id="toc-Research-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Etymology" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Etymology"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Etymology</span> </div> </a> <ul id="toc-Etymology-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Metastasis</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 62 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-62" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">62 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A7%D9%86%D8%A8%D8%AB%D8%A7%D8%AB" title="انبثاث – Arabic" lang="ar" hreflang="ar" data-title="انبثاث" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-gn mw-list-item"><a href="https://gn.wikipedia.org/wiki/Akyt%C3%A3%27ai_%C3%B1emuas%C3%A3i" title="Akytã'ai ñemuasãi – Guarani" lang="gn" hreflang="gn" data-title="Akytã'ai ñemuasãi" data-language-autonym="Avañe'ẽ" data-language-local-name="Guarani" class="interlanguage-link-target"><span>Avañe'ẽ</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%AE%E0%A7%87%E0%A6%9F%E0%A6%BE%E0%A6%B8%E0%A7%8D%E0%A6%9F%E0%A7%8D%E0%A6%AF%E0%A6%BE%E0%A6%B8%E0%A6%BF%E0%A6%B8" title="মেটাস্ট্যাসিস – Bangla" lang="bn" hreflang="bn" data-title="মেটাস্ট্যাসিস" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-be mw-list-item"><a href="https://be.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Belarusian" lang="be" hreflang="be" data-title="Метастаз" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-be-x-old mw-list-item"><a href="https://be-tarask.wikipedia.org/wiki/%D0%9C%D1%8D%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Мэтастаз – Belarusian (Taraškievica orthography)" lang="be-tarask" hreflang="be-tarask" data-title="Мэтастаз" data-language-autonym="Беларуская (тарашкевіца)" data-language-local-name="Belarusian (Taraškievica orthography)" class="interlanguage-link-target"><span>Беларуская (тарашкевіца)</span></a></li><li class="interlanguage-link interwiki-bg mw-list-item"><a href="https://bg.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7%D0%B0" title="Метастаза – Bulgarian" lang="bg" hreflang="bg" data-title="Метастаза" data-language-autonym="Български" data-language-local-name="Bulgarian" class="interlanguage-link-target"><span>Български</span></a></li><li class="interlanguage-link interwiki-bs mw-list-item"><a href="https://bs.wikipedia.org/wiki/Metastaza" title="Metastaza – Bosnian" lang="bs" hreflang="bs" data-title="Metastaza" data-language-autonym="Bosanski" data-language-local-name="Bosnian" class="interlanguage-link-target"><span>Bosanski</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Met%C3%A0stasi" title="Metàstasi – Catalan" lang="ca" hreflang="ca" data-title="Metàstasi" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Metast%C3%A1za" title="Metastáza – Czech" lang="cs" hreflang="cs" data-title="Metastáza" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-da mw-list-item"><a href="https://da.wikipedia.org/wiki/Metastase" title="Metastase – Danish" lang="da" hreflang="da" data-title="Metastase" data-language-autonym="Dansk" data-language-local-name="Danish" class="interlanguage-link-target"><span>Dansk</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Metastase" title="Metastase – German" lang="de" hreflang="de" data-title="Metastase" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/Metastaas" title="Metastaas – Estonian" lang="et" hreflang="et" data-title="Metastaas" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%9C%CE%B5%CF%84%CE%AC%CF%83%CF%84%CE%B1%CF%83%CE%B7" title="Μετάσταση – Greek" lang="el" hreflang="el" data-title="Μετάσταση" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Met%C3%A1stasis" title="Metástasis – Spanish" lang="es" hreflang="es" data-title="Metástasis" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eo mw-list-item"><a href="https://eo.wikipedia.org/wiki/Metastazo" title="Metastazo – Esperanto" lang="eo" hreflang="eo" data-title="Metastazo" data-language-autonym="Esperanto" data-language-local-name="Esperanto" class="interlanguage-link-target"><span>Esperanto</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Metastasi" title="Metastasi – Basque" lang="eu" hreflang="eu" data-title="Metastasi" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%85%D8%AA%D8%A7%D8%B3%D8%AA%D8%A7%D8%B2" title="متاستاز – Persian" lang="fa" hreflang="fa" data-title="متاستاز" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/M%C3%A9tastase_(m%C3%A9decine)" title="Métastase (médecine) – French" lang="fr" hreflang="fr" data-title="Métastase (médecine)" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ga mw-list-item"><a href="https://ga.wikipedia.org/wiki/Meiteast%C3%A1is" title="Meiteastáis – Irish" lang="ga" hreflang="ga" data-title="Meiteastáis" data-language-autonym="Gaeilge" data-language-local-name="Irish" class="interlanguage-link-target"><span>Gaeilge</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Met%C3%A1stase" title="Metástase – Galician" lang="gl" hreflang="gl" data-title="Metástase" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%A0%84%EC%9D%B4_(%EC%9D%98%ED%95%99)" title="전이 (의학) – Korean" lang="ko" hreflang="ko" data-title="전이 (의학)" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-ha mw-list-item"><a href="https://ha.wikipedia.org/wiki/Metastasis" title="Metastasis – Hausa" lang="ha" hreflang="ha" data-title="Metastasis" data-language-autonym="Hausa" data-language-local-name="Hausa" class="interlanguage-link-target"><span>Hausa</span></a></li><li class="interlanguage-link interwiki-hy mw-list-item"><a href="https://hy.wikipedia.org/wiki/%D5%84%D5%A5%D5%BF%D5%A1%D5%BD%D5%BF%D5%A1%D5%A6" title="Մետաստազ – Armenian" lang="hy" hreflang="hy" data-title="Մետաստազ" data-language-autonym="Հայերեն" data-language-local-name="Armenian" class="interlanguage-link-target"><span>Հայերեն</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Metastaze" title="Metastaze – Croatian" lang="hr" hreflang="hr" data-title="Metastaze" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Metastasis" title="Metastasis – Indonesian" lang="id" hreflang="id" data-title="Metastasis" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Metastasi" title="Metastasi – Italian" lang="it" hreflang="it" data-title="Metastasi" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%92%D7%A8%D7%95%D7%A8%D7%94" title="גרורה – Hebrew" lang="he" hreflang="he" data-title="גרורה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ka mw-list-item"><a href="https://ka.wikipedia.org/wiki/%E1%83%9B%E1%83%94%E1%83%A2%E1%83%90%E1%83%A1%E1%83%A2%E1%83%90%E1%83%96%E1%83%98" title="მეტასტაზი – Georgian" lang="ka" hreflang="ka" data-title="მეტასტაზი" data-language-autonym="ქართული" data-language-local-name="Georgian" class="interlanguage-link-target"><span>ქართული</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Kazakh" lang="kk" hreflang="kk" data-title="Метастаз" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Kyrgyz" lang="ky" hreflang="ky" data-title="Метастаз" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Metastasis" title="Metastasis – Latin" lang="la" hreflang="la" data-title="Metastasis" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Metastaz%C4%97" title="Metastazė – Lithuanian" lang="lt" hreflang="lt" data-title="Metastazė" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-hu mw-list-item"><a href="https://hu.wikipedia.org/wiki/%C3%81tt%C3%A9t" title="Áttét – Hungarian" lang="hu" hreflang="hu" data-title="Áttét" data-language-autonym="Magyar" data-language-local-name="Hungarian" class="interlanguage-link-target"><span>Magyar</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7%D0%B0" title="Метастаза – Macedonian" lang="mk" hreflang="mk" data-title="Метастаза" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Metastasis" title="Metastasis – Malay" lang="ms" hreflang="ms" data-title="Metastasis" data-language-autonym="Bahasa Melayu" data-language-local-name="Malay" class="interlanguage-link-target"><span>Bahasa Melayu</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Uitzaaiing" title="Uitzaaiing – Dutch" lang="nl" hreflang="nl" data-title="Uitzaaiing" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E8%BB%A2%E7%A7%BB_(%E5%8C%BB%E5%AD%A6)" title="転移 (医学) – Japanese" lang="ja" hreflang="ja" data-title="転移 (医学)" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Metastase" title="Metastase – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Metastase" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Metastatisk_sjukdom" title="Metastatisk sjukdom – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Metastatisk sjukdom" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Metastaz" title="Metastaz – Uzbek" lang="uz" hreflang="uz" data-title="Metastaz" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Przerzut_nowotworowy" title="Przerzut nowotworowy – Polish" lang="pl" hreflang="pl" data-title="Przerzut nowotworowy" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Met%C3%A1stase" title="Metástase – Portuguese" lang="pt" hreflang="pt" data-title="Metástase" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Metastaz%C4%83" title="Metastază – Romanian" lang="ro" hreflang="ro" data-title="Metastază" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Russian" lang="ru" hreflang="ru" data-title="Метастаз" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Metastasis" title="Metastasis – Simple English" lang="en-simple" hreflang="en-simple" data-title="Metastasis" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Metast%C3%A1za" title="Metastáza – Slovak" lang="sk" hreflang="sk" data-title="Metastáza" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Zasevek" title="Zasevek – Slovenian" lang="sl" hreflang="sl" data-title="Zasevek" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Metastaza" title="Metastaza – Serbian" lang="sr" hreflang="sr" data-title="Metastaza" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Metastaza" title="Metastaza – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Metastaza" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Et%C3%A4pes%C3%A4ke" title="Etäpesäke – Finnish" lang="fi" hreflang="fi" data-title="Etäpesäke" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Metastas" title="Metastas – Swedish" lang="sv" hreflang="sv" data-title="Metastas" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Metastasis" title="Metastasis – Tagalog" lang="tl" hreflang="tl" data-title="Metastasis" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-ta mw-list-item"><a href="https://ta.wikipedia.org/wiki/%E0%AE%AE%E0%AE%BE%E0%AE%B1%E0%AF%8D%E0%AE%B1%E0%AE%BF%E0%AE%9F%E0%AE%AE%E0%AF%8D_%E0%AE%AA%E0%AF%81%E0%AE%95%E0%AE%B2%E0%AF%8D" title="மாற்றிடம் புகல் – Tamil" lang="ta" hreflang="ta" data-title="மாற்றிடம் புகல்" data-language-autonym="தமிழ்" data-language-local-name="Tamil" class="interlanguage-link-target"><span>தமிழ்</span></a></li><li class="interlanguage-link interwiki-tt mw-list-item"><a href="https://tt.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Tatar" lang="tt" hreflang="tt" data-title="Метастаз" data-language-autonym="Татарча / tatarça" data-language-local-name="Tatar" class="interlanguage-link-target"><span>Татарча / tatarça</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B9%81%E0%B8%9E%E0%B8%A3%E0%B9%88%E0%B8%81%E0%B8%A3%E0%B8%B0%E0%B8%88%E0%B8%B2%E0%B8%A2" title="การแพร่กระจาย – Thai" lang="th" hreflang="th" data-title="การแพร่กระจาย" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Metastaz" title="Metastaz – Turkish" lang="tr" hreflang="tr" data-title="Metastaz" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%9C%D0%B5%D1%82%D0%B0%D1%81%D1%82%D0%B0%D0%B7" title="Метастаз – Ukrainian" lang="uk" hreflang="uk" data-title="Метастаз" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D8%AA%D8%AD%D9%88%D9%84_(%D9%81%D8%B9%D9%84%DB%8C%D8%A7%D8%AA)" title="تحول (فعلیات) – Urdu" lang="ur" hreflang="ur" data-title="تحول (فعلیات)" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Di_c%C4%83n" title="Di căn – Vietnamese" lang="vi" hreflang="vi" data-title="Di căn" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-war mw-list-item"><a href="https://war.wikipedia.org/wiki/Metastasis" title="Metastasis – Waray" lang="war" hreflang="war" data-title="Metastasis" data-language-autonym="Winaray" data-language-local-name="Waray" class="interlanguage-link-target"><span>Winaray</span></a></li><li class="interlanguage-link interwiki-wuu mw-list-item"><a href="https://wuu.wikipedia.org/wiki/%E8%BF%9C%E7%AB%AF%E8%BD%AC%E7%A7%BB" title="远端转移 – Wu" lang="wuu" hreflang="wuu" data-title="远端转移" data-language-autonym="吴语" data-language-local-name="Wu" class="interlanguage-link-target"><span>吴语</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%81%A0%E7%AB%AF%E8%BD%89%E7%A7%BB" title="遠端轉移 – Chinese" lang="zh" hreflang="zh" data-title="遠端轉移" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q181876#sitelinks-wikipedia" title="Edit 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data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For the musical composition, see <a href="/wiki/Metastaseis_(Xenakis)" title="Metastaseis (Xenakis)">Metastaseis (Xenakis)</a>. For the film, see <a href="/wiki/Metastases_(film)" title="Metastases (film)">Metastases (film)</a>. For the Spanish-language remake of <i>Breaking Bad</i>, see <a href="/wiki/Met%C3%A1stasis" title="Metástasis">Metástasis</a>.</div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Lymph_node_metastasis,_squamous_cell_carcinoma_bromchus.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg/220px-Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg" decoding="async" width="220" height="147" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/e5/Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg/330px-Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/e5/Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg/440px-Lymph_node_metastasis%2C_squamous_cell_carcinoma_bromchus.jpg 2x" data-file-width="2816" data-file-height="1876" /></a><figcaption>Squamous cell carcinoma occluding bronchus with metastasis to adjacent lymph node.</figcaption></figure> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Metastasis</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Metastatic disease</td></tr><tr style="background-color: #f8f9fa;"><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Metastasis_illustration.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Metastasis_illustration.jpg/220px-Metastasis_illustration.jpg" decoding="async" width="220" height="330" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/89/Metastasis_illustration.jpg/330px-Metastasis_illustration.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/89/Metastasis_illustration.jpg/440px-Metastasis_illustration.jpg 2x" data-file-width="1800" data-file-height="2700" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Illustration showing hematogenous metastasis</td></tr><tr><th scope="row" class="infobox-label">Pronunciation</th><td class="infobox-data"><style data-mw-deduplicate="TemplateStyles:r1126788409">.mw-parser-output .plainlist ol,.mw-parser-output .plainlist ul{line-height:inherit;list-style:none;margin:0;padding:0}.mw-parser-output .plainlist ol li,.mw-parser-output .plainlist ul li{margin-bottom:0}</style><div class="plainlist"><ul><li>Metastasis /mᵻˈtastəsɪs/ metastases <span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="'m' in 'my'">m</span><span title="/ə/: 'a' in 'about'">ə</span></span><span class="wrap"> </span><span style="border-bottom:1px dotted"><span title="/ˈ/: primary stress follows">ˈ</span><span title="'t' in 'tie'">t</span><span title="/æ/: 'a' in 'bad'">æ</span><span title="'s' in 'sigh'">s</span></span><span class="wrap"> </span><span style="border-bottom:1px dotted"><span title="'t' in 'tie'">t</span><span title="/ə/: 'a' in 'about'">ə</span></span><span class="wrap"> </span><span style="border-bottom:1px dotted"><span title="'s' in 'sigh'">s</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'z' in 'zoom'">z</span></span>/</a></span></span> </li></ul></div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Oncology" title="Oncology">Oncology</a></td></tr></tbody></table> <p><b>Metastasis</b> is a <a href="/wiki/Pathogen" title="Pathogen">pathogenic</a> agent's spreading from an initial or primary site to a different or secondary site within the host's body;<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> the term is typically used when referring to metastasis by a <a href="/wiki/Cancer" title="Cancer">cancerous</a> tumor.<sup id="cite_ref-cancernet_2-0" class="reference"><a href="#cite_note-cancernet-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The newly pathological sites, then, are <b>metastases</b> (<b>mets</b>).<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> It is generally distinguished from <a href="/wiki/Cancer_invasion" class="mw-redirect" title="Cancer invasion">cancer invasion</a>, which is the direct extension and penetration by cancer cells into neighboring tissues.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p><p>Cancer occurs after cells are genetically altered to proliferate rapidly and indefinitely. This uncontrolled proliferation by <a href="/wiki/Mitosis" title="Mitosis">mitosis</a> produces a <a href="/wiki/Primary_tumor" title="Primary tumor">primary</a> <a href="/wiki/Tumour_heterogeneity" title="Tumour heterogeneity">heterogeneic tumour</a>. The cells which constitute the tumor eventually undergo <a href="/wiki/Metaplasia" title="Metaplasia">metaplasia</a>, followed by <a href="/wiki/Dysplasia" title="Dysplasia">dysplasia</a> then <a href="/wiki/Anaplasia" title="Anaplasia">anaplasia</a>, resulting in a <a href="/wiki/Malignancy" title="Malignancy">malignant</a> phenotype. This malignancy allows for invasion into the circulation, followed by invasion to a second site for <a href="/wiki/Tumorigenesis" class="mw-redirect" title="Tumorigenesis">tumorigenesis</a>. </p><p>Some cancer cells, known as <a href="/wiki/Circulating_tumor_cells" class="mw-redirect" title="Circulating tumor cells">circulating tumor cells</a> (CTCs), are able to penetrate the walls of <a href="/wiki/Lymphatic_vessel" title="Lymphatic vessel">lymphatic</a> or <a href="/wiki/Blood_vessel" title="Blood vessel">blood vessels</a>, and circulate through the bloodstream to other sites and tissues in the body.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> This process, known respectively as <i>lymphatic</i> or <i>hematogenous</i> spread, allows not only single cells but also groups of cells, or <a href="/wiki/Cancer_Exodus_Hypothesis" class="mw-redirect" title="Cancer Exodus Hypothesis">CTC clusters</a>, to travel. Evidence suggests that CTC clusters may retain their multicellular configuration throughout metastasis, enhancing their ability to establish secondary tumors.<sup id="cite_ref-Aceto_7-0" class="reference"><a href="#cite_note-Aceto-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> This perspective aligns with the <a href="/wiki/Cancer_exodus_hypothesis" title="Cancer exodus hypothesis">cancer exodus hypothesis</a>, which posits that maintaining this cluster structure contributes to a higher metastatic potential. Metastasis is one of the <a href="/wiki/The_Hallmarks_of_Cancer" title="The Hallmarks of Cancer">hallmarks of cancer</a>, distinguishing it from <a href="/wiki/Benign_tumor" title="Benign tumor">benign tumors</a>.<sup id="cite_ref-Robbins_8-0" class="reference"><a href="#cite_note-Robbins-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Most cancers can metastasize, although in varying degrees. <a href="/wiki/Basal_cell_carcinoma" class="mw-redirect" title="Basal cell carcinoma">Basal cell carcinoma</a> for example rarely metastasizes.<sup id="cite_ref-Robbins_8-1" class="reference"><a href="#cite_note-Robbins-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>When tumor cells metastasize, the new tumor is called a <i>secondary</i> or <i>metastatic</i> tumor, and its cells are similar to those in the original or <a href="/wiki/Primary_tumor" title="Primary tumor">primary tumor</a>.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> This means that if <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a> metastasizes to the lungs, the secondary tumor is made up of abnormal breast cells, not of abnormal lung cells. The tumor in the lung is then called <i>metastatic breast cancer</i>, not <i>lung cancer</i>. Metastasis is a key element in <a href="/wiki/Cancer_staging" title="Cancer staging">cancer staging</a> systems such as the <a href="/wiki/TNM_staging_system" title="TNM staging system">TNM staging system</a>, where it represents the "M". In <a href="/wiki/Cancer_staging#Overall_stage_grouping" title="Cancer staging">overall stage grouping</a>, metastasis places a cancer in Stage IV. The possibilities of curative treatment are greatly reduced, or often entirely removed when a cancer has metastasized. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=1" title="Edit section: Signs and symptoms"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg/220px-Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg" decoding="async" width="220" height="149" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/5/53/Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg/330px-Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/5/53/Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg/440px-Secondary_tumor_deposits_in_the_liver_from_a_primary_cancer_of_the_pancreas.jpg 2x" data-file-width="2784" data-file-height="1884" /></a><figcaption>Cut surface of a <a href="/wiki/Liver" title="Liver">liver</a> showing multiple paler metastatic nodules originating from <a href="/wiki/Pancreatic_cancer" title="Pancreatic cancer">pancreatic cancer</a></figcaption></figure> <p>Initially, nearby lymph nodes are struck early.<sup id="cite_ref-nci_10-0" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Lungs" class="mw-redirect" title="Lungs">lungs</a>, <a href="/wiki/Liver" title="Liver">liver</a>, <a href="/wiki/Brain" title="Brain">brain</a>, and <a href="/wiki/Bone" title="Bone">bones</a> are the most common metastasis locations from solid tumors.<sup id="cite_ref-nci_10-1" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p> <ul><li>In <a href="/wiki/Lymph_node_metastasis" title="Lymph node metastasis">lymph node metastasis</a>, a common symptom is <a href="/wiki/Lymphadenopathy" title="Lymphadenopathy">lymphadenopathy</a></li> <li><a href="/wiki/Lung_cancer#Metastasis" title="Lung cancer">Lung metastasis</a>: <a href="/wiki/Cough" title="Cough">cough</a>, <a href="/wiki/Hemoptysis" title="Hemoptysis">hemoptysis</a> and <a href="/wiki/Dyspnea" class="mw-redirect" title="Dyspnea">dyspnea</a><sup id="cite_ref-nci_10-2" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> (shortness of breath)</li> <li><a href="/wiki/Metastatic_liver_disease" class="mw-redirect" title="Metastatic liver disease">Liver metastasis</a>: <a href="/wiki/Hepatomegaly" title="Hepatomegaly">hepatomegaly</a> (enlarged <a href="/wiki/Liver" title="Liver">liver</a>), <a href="/wiki/Nausea" title="Nausea">nausea</a><sup id="cite_ref-nci_10-3" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Jaundice" title="Jaundice">jaundice</a><sup id="cite_ref-nci_10-4" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Bone_metastasis" title="Bone metastasis">Bone metastasis</a>: bone pain,<sup id="cite_ref-nci_10-5" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Fracture" title="Fracture">fracture</a> of affected bones<sup id="cite_ref-nci_10-6" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Brain_metastasis" title="Brain metastasis">Brain metastasis</a>: <a href="/wiki/Neurology" title="Neurology">neurological</a> symptoms such as headaches,<sup id="cite_ref-nci_10-7" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> seizures,<sup id="cite_ref-nci_10-8" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Vertigo_(medical)" class="mw-redirect" title="Vertigo (medical)">vertigo</a><sup id="cite_ref-nci_10-9" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup></li></ul> <p>Although advanced cancer may cause <a href="/wiki/Pain" title="Pain">pain</a>, it is often not the first symptom. </p><p>Some patients, however, do not show any symptoms.<sup id="cite_ref-nci_10-10" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> When the organ gets a metastatic disease it begins to shrink until its <a href="/wiki/Lymph_nodes" class="mw-redirect" title="Lymph nodes">lymph nodes</a> burst, or undergo <a href="/wiki/Lysis" title="Lysis">lysis</a>. </p> <div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=2" title="Edit section: Pathophysiology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Metastatic tumors are very common in the late stages of cancer. The spread of metastasis may occur via the blood or the lymphatics or through both routes. The most common sites of metastases are the <a href="/wiki/Lung" title="Lung">lungs</a>, <a href="/wiki/Liver" title="Liver">liver</a>, <a href="/wiki/Brain" title="Brain">brain</a>, and the <a href="/wiki/Bone" title="Bone">bones</a><sup id="cite_ref-nci_10-11" class="reference"><a href="#cite_note-nci-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>Currently, three main theories have been proposed to explain the metastatic pathway of cancer: the epithelial-mesenchymal transition (EMT) and mesenchymal-epithelial transition (MET) hypothesis (1), the cancer stem cell hypothesis (2), and the macrophage–cancer cell fusion hybrid hypothesis (3). Some new hypotheses were suggested as well, i.e., under the effect of particular biochemical and/or physical stressors, cancer cells can undergo nuclear expulsion with subsequent macrophage engulfment and fusion, with the formation of cancer fusion cells (CFCs).<sup id="cite_ref-Olteanu_2020_11-0" class="reference"><a href="#cite_note-Olteanu_2020-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Understanding the enigma of cancer cell spread to distant sites, which accounts for over 90% of cancer-related deaths, necessitates comprehensive investigation. Key outstanding questions revolve around the survival and migration of cancer cells, such as the nucleus, as they face challenges in passage through capillary valves and hydrodynamic shear forces in the circulation system, making CTCs an unlikely source of metastasis. Moreover, understanding how cancer cells adapt to the metastatic niche and remain dormant (tumor dormancy) for extended periods presents difficult questions that require further investigation.<sup id="cite_ref-Olteanu_2020_11-1" class="reference"><a href="#cite_note-Olteanu_2020-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Factors_involved">Factors involved</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=3" title="Edit section: Factors involved"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Metastasis involves a complex series of steps in which cancer cells leave the original tumor site and migrate to other parts of the body via the bloodstream, via the lymphatic system, or by direct extension. To do so, malignant cells break away from the primary tumor and attach to and degrade <a href="/wiki/Protein" title="Protein">proteins</a> that make up the surrounding <a href="/wiki/Extracellular_matrix" title="Extracellular matrix">extracellular matrix</a> (ECM), which separates the tumor from adjoining tissues. By degrading these proteins, cancer cells are able to breach the ECM and escape. The location of the metastases is not always random, with different types of cancer tending to spread to particular organs and tissues at a rate that is higher than expected by statistical chance alone.<sup id="cite_ref-Nguyen_2007_12-0" class="reference"><a href="#cite_note-Nguyen_2007-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Breast cancer, for example, tends to metastasize to the bones and lungs. This specificity seems to be mediated by soluble signal molecules such as <a href="/wiki/Chemokines" class="mw-redirect" title="Chemokines">chemokines</a><sup id="cite_ref-Zlotnik_2011_13-0" class="reference"><a href="#cite_note-Zlotnik_2011-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Transforming_growth_factor_beta" title="Transforming growth factor beta">transforming growth factor beta</a>.<sup id="cite_ref-Drabsch_2011_14-0" class="reference"><a href="#cite_note-Drabsch_2011-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The body resists metastasis by a variety of mechanisms through the actions of a class of proteins known as <a href="/wiki/Metastasis_suppressor" title="Metastasis suppressor">metastasis suppressors</a>, of which about a dozen are known.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> </p><p>Human cells exhibit different kinds of motion: collective <a href="/wiki/Motility" title="Motility">motility</a>, <a href="/wiki/Mesenchyme" title="Mesenchyme">mesenchymal</a>-type movement, and <a href="/wiki/Amoeboid_movement" title="Amoeboid movement">amoeboid movement</a>. Cancer cells often opportunistically switch between different kinds of motion. Some cancer researchers hope to find treatments that can stop or at least slow down the spread of cancer by somehow blocking some necessary step in one or more kinds of motion.<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> </p><p>All steps of the metastatic cascade involve a number of physical processes. Cell migration requires the generation of forces, and when cancer cells transmigrate through the vasculature, this requires physical gaps in the blood vessels to form.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> Besides forces, the regulation of various types of cell-cell and cell-matrix adhesions is crucial during metastasis.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>The metastatic steps are critically regulated by various cell types, including the blood vessel cells (endothelial cells), immune cells or stromal cells. The growth of a new network of blood vessels, called tumor <a href="/wiki/Angiogenesis" title="Angiogenesis">angiogenesis</a>,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> is a crucial <a href="/wiki/The_Hallmarks_of_Cancer" title="The Hallmarks of Cancer">hallmark of cancer.</a> It has therefore been suggested that <a href="/wiki/Angiogenesis_inhibitor" title="Angiogenesis inhibitor">angiogenesis inhibitors</a> would prevent the growth of metastases.<sup id="cite_ref-Robbins_8-2" class="reference"><a href="#cite_note-Robbins-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Endothelial_progenitor_cell" title="Endothelial progenitor cell">Endothelial progenitor cells</a> have been shown to have a strong influence on metastasis and angiogenesis.<sup id="cite_ref-pmid18187653_20-0" class="reference"><a href="#cite_note-pmid18187653-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid17575055_21-0" class="reference"><a href="#cite_note-pmid17575055-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> Endothelial progenitor cells are important in tumor growth, angiogenesis and metastasis, and can be marked using the <a href="/wiki/ID1" title="ID1">Inhibitor of DNA Binding 1</a> (ID1). This novel finding meant that investigators gained the ability to track endothelial progenitor cells from the bone marrow to the blood to the tumor-stroma and even incorporated in tumor vasculature. Endothelial progenitor cells incorporated in tumor vasculature suggests that this cell type in blood-vessel development is important in a tumor setting and metastasis. Furthermore, ablation of the endothelial progenitor cells in the bone marrow can lead to a significant decrease in tumor growth and vasculature development. Therefore, endothelial progenitor cells are important in tumor biology and present novel therapeutic targets.<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> The immune system is typically deregulated in cancer and affects many stages of tumor progression, including metastasis.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p><a href="/wiki/Epigenetics" title="Epigenetics">Epigenetic</a> regulation also plays an important role in the metastatic outgrowth of disseminated tumor cells. Metastases display alterations in histone modifications, such as H3K4-methylation and H3K9-methylation, when compared to matching primary tumors.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> These epigenetic modifications in metastases may allow the proliferation and survival of disseminated tumor cells in distant organs.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> </p><p>A recent study shows that PKC-iota promotes melanoma cell invasion by activating Vimentin during EMT. PKC-iota inhibition or knockdown resulted in an increase in E-cadherin and RhoA levels while decreasing total Vimentin, phosphorylated Vimentin (S39) and Par6 in metastatic melanoma cells. These results suggested that PKC-ι is involved in signaling pathways which upregulate EMT in melanoma thereby directly stimulates metastasis.<sup id="cite_ref-pmid29048609_25-0" class="reference"><a href="#cite_note-pmid29048609-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p><p>Recently, a series of high-profile experiments suggests that the co-option of intercellular cross-talk mediated by exosome vesicles is a critical factor involved in all steps of the invasion-metastasis cascade.<sup id="cite_ref-Syn_2016_26-0" class="reference"><a href="#cite_note-Syn_2016-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Routes">Routes</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=4" title="Edit section: Routes"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Metastasis occurs by the following four routes: </p> <div class="mw-heading mw-heading4"><h4 id="Transcoelomic">Transcoelomic</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=5" title="Edit section: Transcoelomic"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The spread of a malignancy into body cavities can occur via penetrating the surface of the <a href="/wiki/Peritoneal_cavity" title="Peritoneal cavity">peritoneal</a>, <a href="/wiki/Pleural_cavity" title="Pleural cavity">pleural</a>, pericardial, or subarachnoid spaces. For example, <a href="/wiki/Ovarian_cancer" title="Ovarian cancer">ovarian tumors</a> can spread transperitoneally to the surface of the liver.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Lymphatic_spread">Lymphatic spread</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=6" title="Edit section: Lymphatic spread"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Lymphatic spread allows the transport of tumor cells to regional <a href="/wiki/Lymph_node" title="Lymph node">lymph nodes</a> near the primary tumor and ultimately, to other parts of the body. This is called nodal involvement, positive nodes, or regional disease. "Positive nodes" is a term that would be used by medical specialists to describe regional lymph nodes that tested positive for malignancy. It is common medical practice to test by biopsy at least one lymph node near a tumor site when carrying out surgery to examine or remove a tumor. This lymph node is then called a <a href="/wiki/Sentinel_lymph_node" title="Sentinel lymph node">sentinel lymph node</a>. Lymphatic spread is the most common route of initial metastasis for <a href="/wiki/Carcinoma" title="Carcinoma">carcinomas</a>.<sup id="cite_ref-Robbins_8-3" class="reference"><a href="#cite_note-Robbins-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> In contrast, it is uncommon for a <a href="/wiki/Sarcoma" title="Sarcoma">sarcoma</a> to metastasize via this route. Localized spread to regional lymph nodes near the primary tumor is not normally counted as a metastasis, although this is a sign of a worse <a href="/wiki/Prognosis" title="Prognosis">outcome</a>. The lymphatic system does eventually drain from the <a href="/wiki/Thoracic_duct" title="Thoracic duct">thoracic duct</a> and <a href="/wiki/Right_lymphatic_duct" title="Right lymphatic duct">right lymphatic duct</a> into the systemic venous system at the <a href="/wiki/Venous_angle" title="Venous angle">venous angle</a> and into the <a href="/wiki/Brachiocephalic_vein" title="Brachiocephalic vein">brachiocephalic veins</a>, and therefore these metastatic cells can also eventually spread through the haematogenous route.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Lymph_node_with_metastatic_melanoma.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/1f/Lymph_node_with_metastatic_melanoma.jpg/220px-Lymph_node_with_metastatic_melanoma.jpg" decoding="async" width="220" height="146" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/1f/Lymph_node_with_metastatic_melanoma.jpg/330px-Lymph_node_with_metastatic_melanoma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/1f/Lymph_node_with_metastatic_melanoma.jpg/440px-Lymph_node_with_metastatic_melanoma.jpg 2x" data-file-width="2598" data-file-height="1722" /></a><figcaption>Lymph node with almost complete replacement by metastatic melanoma. The brown pigment is focal deposition of melanin</figcaption></figure> <div class="mw-heading mw-heading4"><h4 id="Hematogenous_spread">Hematogenous spread</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=7" title="Edit section: Hematogenous spread"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>This is typical route of metastasis for sarcomas, but it is also the favored route for certain types of carcinoma, such as <a href="/wiki/Renal_cell_carcinoma" title="Renal cell carcinoma">renal cell carcinoma</a> originating in the <a href="/wiki/Kidney" title="Kidney">kidney</a> and follicular carcinomas of the thyroid. Because of their thinner walls, veins are more frequently invaded than are arteries, and metastasis tends to follow the pattern of <a href="/wiki/Venous_blood" title="Venous blood">venous flow</a>. That is, hematogenous spread often follows distinct patterns depending on the location of the primary tumor. For example, <a href="/wiki/Colorectal_cancer" title="Colorectal cancer">colorectal cancer</a> spreads primarily through the <a href="/wiki/Portal_vein" title="Portal vein">portal vein</a> to the liver.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading4"><h4 id="Canalicular_spread">Canalicular spread</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=8" title="Edit section: Canalicular spread"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Some tumors, especially <a href="/wiki/Carcinoma" title="Carcinoma">carcinomas</a> may metastasize along anatomical canalicular spaces. These spaces include for example the bile ducts, the urinary system, the airways and the <a href="/wiki/Subarachnoid_space" class="mw-redirect" title="Subarachnoid space">subarachnoid space</a>. The process is similar to that of transcoelomic spread. However, often it remains unclear whether simultaneously diagnosed tumors of a canalicular system are one metastatic process or in fact independent tumors caused by the same agent (<a href="/wiki/Field_cancerization" title="Field cancerization">field cancerization</a>).<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="Organ-specific_targets">Organ-specific targets</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=9" title="Edit section: Organ-specific targets"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Metastasis_sites_for_common_cancers.svg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Metastasis_sites_for_common_cancers.svg/240px-Metastasis_sites_for_common_cancers.svg.png" decoding="async" width="240" height="385" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Metastasis_sites_for_common_cancers.svg/360px-Metastasis_sites_for_common_cancers.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Metastasis_sites_for_common_cancers.svg/480px-Metastasis_sites_for_common_cancers.svg.png 2x" data-file-width="680" data-file-height="1090" /></a><figcaption>Main sites of metastases for some common cancer types. Primary cancers are denoted by "<i>...cancer</i>" and their main metastasis sites are denoted by "<i>...metastases</i>".<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>There is a propensity for certain tumors to seed in particular organs. This was first discussed as the <b>seed and soil theory</b> by <a href="/wiki/Stephen_Paget" title="Stephen Paget">Stephen Paget</a> in 1889.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> The propensity for a metastatic cell to spread to a particular organ is termed 'organotropism'. For example, <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a> usually metastasizes to the bones. In a similar manner, <a href="/wiki/Colon_cancer" class="mw-redirect" title="Colon cancer">colon cancer</a> has a tendency to metastasize to the liver. <a href="/wiki/Stomach_cancer" title="Stomach cancer">Stomach cancer</a> often metastasises to the <a href="/wiki/Ovary" title="Ovary">ovary</a> in women, when it is called a <a href="/wiki/Krukenberg_tumor" title="Krukenberg tumor">Krukenberg tumor</a>.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>According to the seed and soil theory, it is difficult for cancer cells to survive outside their region of origin, so in order to metastasize they must find a location with similar characteristics.<sup id="cite_ref-Hart_1982_29-0" class="reference"><a href="#cite_note-Hart_1982-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> For example, breast tumor cells, which gather calcium <a href="/wiki/Ion" title="Ion">ions</a> from breast milk, metastasize to bone tissue, where they can gather calcium ions from bone. Malignant <a href="/wiki/Melanoma" title="Melanoma">melanoma</a> spreads to the brain, presumably because <a href="/wiki/Neural" class="mw-redirect" title="Neural">neural</a> tissue and <a href="/wiki/Melanocyte" title="Melanocyte">melanocytes</a> arise from the same <a href="/wiki/Cell_line" class="mw-redirect" title="Cell line">cell line</a> in the <a href="/wiki/Embryo" title="Embryo">embryo</a>.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>In 1928, <a href="/wiki/James_Ewing_(pathologist)" title="James Ewing (pathologist)">James Ewing</a> challenged the seed and soil theory, and proposed that metastasis occurs purely by anatomic and mechanical routes. This hypothesis has been recently utilized to suggest several hypotheses about the life cycle of circulating tumor cells (CTCs) and to postulate that the patterns of spread could be better understood through a 'filter and flow' perspective.<sup id="cite_ref-filterflow_31-0" class="reference"><a href="#cite_note-filterflow-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> However, contemporary evidences indicate that the primary tumour may dictate organotropic metastases by inducing the formation of <a href="/wiki/Pre-metastatic_niche" title="Pre-metastatic niche">pre-metastatic niches</a> at distant sites, where incoming metastatic cells may engraft and colonise.<sup id="cite_ref-Syn_2016_26-1" class="reference"><a href="#cite_note-Syn_2016-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Specifically, exosome vesicles secreted by tumours have been shown to home to pre-metastatic sites, where they activate pro-metastatic processes such as angiogenesis and modify the immune contexture, so as to foster a favourable microenvironment for secondary tumour growth.<sup id="cite_ref-Syn_2016_26-2" class="reference"><a href="#cite_note-Syn_2016-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Metastasis_and_primary_cancer">Metastasis and primary cancer</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=10" title="Edit section: Metastasis and primary cancer"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>It is theorized that metastasis always coincides with a primary cancer, and, as such, is a tumor that started from a cancer cell or cells in another part of the body. However, over 10% of patients presenting to <a href="/wiki/Oncology_unit" class="mw-redirect" title="Oncology unit">oncology units</a> will have metastases without a primary tumor found. In these cases, doctors refer to the primary tumor as "unknown" or "occult," and the patient is said to have <a href="/wiki/Cancer_of_unknown_primary_origin" title="Cancer of unknown primary origin">cancer of unknown primary origin</a> (CUP) or <a href="/wiki/Unknown_primary_tumors" class="mw-redirect" title="Unknown primary tumors">unknown primary tumors</a> (UPT).<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> It is estimated that 3% of all cancers are of unknown primary origin.<sup id="cite_ref-CUP-Oncologist_33-0" class="reference"><a href="#cite_note-CUP-Oncologist-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> Studies have shown that, if simple questioning does not reveal the cancer's source (coughing up blood—"probably <a href="/wiki/Lung_cancer" title="Lung cancer">lung</a>", urinating blood—"probably <a href="/wiki/Bladder_cancer" title="Bladder cancer">bladder</a>"), complex imaging will not either.<sup id="cite_ref-CUP-Oncologist_33-1" class="reference"><a href="#cite_note-CUP-Oncologist-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> In some of these cases a primary tumor may appear later.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>The use of <a href="/wiki/Immunohistochemistry" title="Immunohistochemistry">immunohistochemistry</a> has permitted pathologists to give an identity to many of these metastases. However, imaging of the indicated area only occasionally reveals a primary. In rare cases (e.g., of <a href="/wiki/Melanoma" title="Melanoma">melanoma</a>), no primary tumor is found, even on <a href="/wiki/Autopsy" title="Autopsy">autopsy</a>. It is therefore thought that some primary tumors can regress completely, but leave their metastases behind. In other cases, the tumor might just be too small and/or in an unusual location to be diagnosed.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=11" title="Edit section: Diagnosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg/220px-Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg" decoding="async" width="220" height="249" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg/330px-Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cd/Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg/440px-Pulmonary_metastases_shown_on_Chest_X-Ray_.jpg 2x" data-file-width="3024" data-file-height="3424" /></a><figcaption>Pulmonary metastases shown on Chest X-Ray</figcaption></figure> <p>The cells in a metastatic tumor resemble those in the primary tumor. Once the cancerous tissue is examined under a microscope to determine the cell type, a doctor can usually tell whether that type of cell is normally found in the part of the body from which the tissue sample was taken.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (September 2024)">citation needed</span></a></i>]</sup> </p><p>For instance, <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a> cells look the same whether they are found in the breast or have spread to another part of the body. So, if a tissue sample taken from a tumor in the lung contains cells that look like breast cells, the doctor determines that the lung tumor is a secondary tumor. Still, the determination of the primary tumor can often be very difficult, and the pathologist may have to use several adjuvant techniques, such as <a href="/wiki/Immunohistochemistry" title="Immunohistochemistry">immunohistochemistry</a>, FISH (<a href="/wiki/Fluorescent_in_situ_hybridization" class="mw-redirect" title="Fluorescent in situ hybridization">fluorescent in situ hybridization</a>), and others. Despite the use of techniques, in some cases the primary tumor remains unidentified. </p><p>Metastatic cancers may be found at the same time as the primary tumor, or months or years later. When a second tumor is found in a patient that has been treated for cancer in the past, it is more often a metastasis than another primary tumor. </p><p>It was previously thought that most cancer cells have a low metastatic potential and that there are rare cells that develop the ability to metastasize through the development of somatic mutations.<sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup> According to this theory, diagnosis of metastatic cancers is only possible after the event of metastasis. Traditional means of diagnosing cancer (e.g. a <a href="/wiki/Biopsy" title="Biopsy">biopsy</a>) would only investigate a subpopulation of the cancer cells and would very likely not sample from the subpopulation with metastatic potential.<sup id="cite_ref-signature_35-0" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>The <a href="/wiki/Somatic_(biology)" title="Somatic (biology)">somatic</a> mutation theory of metastasis development has not been substantiated in human cancers. Rather, it seems that the genetic state of the primary tumor reflects the ability of that cancer to metastasize.<sup id="cite_ref-signature_35-1" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> Research comparing gene expression between primary and metastatic <a href="/wiki/Adenocarcinomas" class="mw-redirect" title="Adenocarcinomas">adenocarcinomas</a> identified a subset of genes whose expression could distinguish primary tumors from metastatic tumors, dubbed a "metastatic signature."<sup id="cite_ref-signature_35-2" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> Up-regulated genes in the signature include: <a href="/wiki/SNRPF" class="mw-redirect" title="SNRPF">SNRPF</a>, <a href="/wiki/HNRPAB" class="mw-redirect" title="HNRPAB">HNRPAB</a>, <a href="/wiki/DHPS" title="DHPS">DHPS</a> and <a href="/wiki/Securin" title="Securin">securin</a>. <a href="/wiki/Actin" title="Actin">Actin</a>, <a href="/wiki/Myosin" title="Myosin">myosin</a> and <a href="/wiki/MHC_class_II" title="MHC class II">MHC class II</a> down-regulation was also associated with the signature. Additionally, the metastatic-associated expression of these genes was also observed in some primary tumors, indicating that cells with the potential to metastasize could be identified concurrently with diagnosis of the primary tumor.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup> Recent work identified a form of genetic instability in cancer called <a href="/wiki/Chromosome_instability" title="Chromosome instability">chromosome instability</a> (CIN) as a driver of metastasis.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup> In aggressive cancer cells, loose DNA fragments from unstable chromosomes spill in the cytosol leading to the chronic activation of innate immune pathways, which are hijacked by cancer cells to spread to distant organs. </p><p>Expression of this metastatic signature has been correlated with a poor prognosis and has been shown to be consistent in several types of cancer. Prognosis was shown to be worse for individuals whose primary tumors expressed the metastatic signature.<sup id="cite_ref-signature_35-3" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> Additionally, the expression of these metastatic-associated genes was shown to apply to other cancer types in addition to <a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">adenocarcinoma</a>. Metastases of <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a>, <a href="/wiki/Medulloblastoma" title="Medulloblastoma">medulloblastoma</a> and <a href="/wiki/Prostate_cancer" title="Prostate cancer">prostate cancer</a> all had similar expression patterns of these metastasis-associated genes.<sup id="cite_ref-signature_35-4" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p><p>The identification of this metastasis-associated signature provides promise for identifying cells with metastatic potential within the primary tumor and hope for improving the prognosis of these metastatic-associated cancers. Additionally, identifying the genes whose expression is changed in metastasis offers potential targets to inhibit metastasis.<sup id="cite_ref-signature_35-5" class="reference"><a href="#cite_note-signature-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup> </p> <ul class="gallery mw-gallery-traditional"> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Bone_metastasis.jpg" class="mw-file-description" title="Cut surface of a humerus sawn lengthwise, showing a large cancerous metastasis (the whitish tumor between the head and the shaft of the bone)"><img alt="Cut surface of a humerus sawn lengthwise, showing a large cancerous metastasis (the whitish tumor between the head and the shaft of the bone)" src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Bone_metastasis.jpg/75px-Bone_metastasis.jpg" decoding="async" width="75" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Bone_metastasis.jpg/113px-Bone_metastasis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3f/Bone_metastasis.jpg/151px-Bone_metastasis.jpg 2x" data-file-width="400" data-file-height="636" /></a></span></div> <div class="gallerytext">Cut surface of a <a href="/wiki/Humerus" title="Humerus">humerus</a> sawn lengthwise, showing a large <a href="/wiki/Cancer" title="Cancer">cancerous</a> metastasis (the whitish tumor between the head and the shaft of the bone)</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Lymph_node_with_papillary_thyroid_carcinoma.jpg" class="mw-file-description" title="Micrograph of thyroid cancer (papillary thyroid carcinoma) in a lymph node of the neck. H&E stain"><img alt="Micrograph of thyroid cancer (papillary thyroid carcinoma) in a lymph node of the neck. H&E stain" src="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Lymph_node_with_papillary_thyroid_carcinoma.jpg/120px-Lymph_node_with_papillary_thyroid_carcinoma.jpg" decoding="async" width="120" height="115" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/47/Lymph_node_with_papillary_thyroid_carcinoma.jpg/180px-Lymph_node_with_papillary_thyroid_carcinoma.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/47/Lymph_node_with_papillary_thyroid_carcinoma.jpg/240px-Lymph_node_with_papillary_thyroid_carcinoma.jpg 2x" data-file-width="1410" data-file-height="1356" /></a></span></div> <div class="gallerytext"><a href="/wiki/Micrograph" title="Micrograph">Micrograph</a> of thyroid cancer (<a href="/wiki/Papillary_thyroid_carcinoma" class="mw-redirect" title="Papillary thyroid carcinoma">papillary thyroid carcinoma</a>) in a <a href="/wiki/Lymph_node" title="Lymph node">lymph node</a> of the neck. <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a></div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:MultipleLiverMets2008.jpg" class="mw-file-description" title="CT image of multiple liver metastases"><img alt="CT image of multiple liver metastases" src="//upload.wikimedia.org/wikipedia/commons/thumb/8/81/MultipleLiverMets2008.jpg/120px-MultipleLiverMets2008.jpg" decoding="async" width="120" height="90" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/81/MultipleLiverMets2008.jpg/180px-MultipleLiverMets2008.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/81/MultipleLiverMets2008.jpg/240px-MultipleLiverMets2008.jpg 2x" data-file-width="3072" data-file-height="2304" /></a></span></div> <div class="gallerytext"><a href="/wiki/Ct_scan" class="mw-redirect" title="Ct scan">CT image</a> of multiple liver metastases</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:LungMets2008.jpg" class="mw-file-description" title="CT image of a lung metastasis"><img alt="CT image of a lung metastasis" src="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/LungMets2008.jpg/120px-LungMets2008.jpg" decoding="async" width="120" height="90" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/f/f4/LungMets2008.jpg/180px-LungMets2008.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/f/f4/LungMets2008.jpg/240px-LungMets2008.jpg 2x" data-file-width="3072" data-file-height="2304" /></a></span></div> <div class="gallerytext"><a href="/wiki/Ct_scan" class="mw-redirect" title="Ct scan">CT image</a> of a lung metastasis</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Adenocarcinoma_liver_metastasis.jpg" class="mw-file-description" title="Metastasis proven by liver biopsy (tumor (adenocarcinoma)—lower two-thirds of image). H&E stain."><img alt="Metastasis proven by liver biopsy (tumor (adenocarcinoma)—lower two-thirds of image). H&E stain." src="//upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Adenocarcinoma_liver_metastasis.jpg/62px-Adenocarcinoma_liver_metastasis.jpg" decoding="async" width="62" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Adenocarcinoma_liver_metastasis.jpg/93px-Adenocarcinoma_liver_metastasis.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/3a/Adenocarcinoma_liver_metastasis.jpg/124px-Adenocarcinoma_liver_metastasis.jpg 2x" data-file-width="2216" data-file-height="4272" /></a></span></div> <div class="gallerytext">Metastasis proven by <a href="/wiki/Liver" title="Liver">liver</a> <a href="/wiki/Biopsy" title="Biopsy">biopsy</a> (tumor (<a href="/wiki/Adenocarcinoma" title="Adenocarcinoma">adenocarcinoma</a>)—lower two-thirds of image). <a href="/wiki/H%26E_stain" title="H&E stain">H&E stain</a>.</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:MetsToLungs.png" class="mw-file-description" title="Metastatic cancer in the lungs"><img alt="Metastatic cancer in the lungs" src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c0/MetsToLungs.png/120px-MetsToLungs.png" decoding="async" width="120" height="88" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c0/MetsToLungs.png/180px-MetsToLungs.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c0/MetsToLungs.png/240px-MetsToLungs.png 2x" data-file-width="590" data-file-height="435" /></a></span></div> <div class="gallerytext">Metastatic cancer in the lungs</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:MetstoBrain(LungPri)Mark.png" class="mw-file-description" title="Metastases from the lungs to the brain"><img alt="Metastases from the lungs to the brain" src="//upload.wikimedia.org/wikipedia/commons/thumb/e/ee/MetstoBrain%28LungPri%29Mark.png/93px-MetstoBrain%28LungPri%29Mark.png" decoding="async" width="93" height="120" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/e/ee/MetstoBrain%28LungPri%29Mark.png/140px-MetstoBrain%28LungPri%29Mark.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/e/ee/MetstoBrain%28LungPri%29Mark.png/186px-MetstoBrain%28LungPri%29Mark.png 2x" data-file-width="739" data-file-height="952" /></a></span></div> <div class="gallerytext">Metastases from the lungs to the brain</div> </li> <li class="gallerybox" style="width: 155px"> <div class="thumb" style="width: 150px; height: 150px;"><span typeof="mw:File"><a href="/wiki/File:Metstopancrease.png" class="mw-file-description" title="Metastases from the lungs to the pancreas"><img alt="Metastases from the lungs to the pancreas" src="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Metstopancrease.png/120px-Metstopancrease.png" decoding="async" width="120" height="89" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Metstopancrease.png/180px-Metstopancrease.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/d/d9/Metstopancrease.png/240px-Metstopancrease.png 2x" data-file-width="1003" data-file-height="748" /></a></span></div> <div class="gallerytext">Metastases from the lungs to the pancreas</div> </li> </ul> <div class="mw-heading mw-heading2"><h2 id="Management">Management</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=12" title="Edit section: Management"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Treatment and survival is determined, to a great extent, by whether or not a cancer remains localized or spreads to other locations in the body. If the cancer metastasizes to other tissues or organs it usually dramatically increases a patient's likelihood of death. Some cancers—such as some forms of <a href="/wiki/Leukemia" title="Leukemia">leukemia</a>, a cancer of the blood, or <a href="/wiki/Brain_tumor" title="Brain tumor">malignancies in the brain</a>—can kill without spreading at all. </p><p>Once a cancer has metastasized it may still be treated with <a href="/wiki/Radiosurgery" title="Radiosurgery">radiosurgery</a>, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>, <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, <a href="/wiki/Biological_therapy" class="mw-redirect" title="Biological therapy">biological therapy</a>, <a href="/wiki/Hormone_therapy" title="Hormone therapy">hormone therapy</a>, <a href="/wiki/Surgery" title="Surgery">surgery</a>, or a combination of these interventions ("multimodal therapy"). The choice of treatment depends on many factors, including the type of primary cancer, the size and location of the metastases, the patient's age and general health, and the types of treatments used previously. In patients diagnosed with CUP it is often still possible to treat the disease even when the primary tumor cannot be located. </p><p>Current treatments are rarely able to cure metastatic cancer though some tumors, such as <a href="/wiki/Testicular_cancer" title="Testicular cancer">testicular cancer</a> and <a href="/wiki/Thyroid_cancer" title="Thyroid cancer">thyroid cancer</a>, are usually curable. </p><p><a href="/wiki/Palliative_care" title="Palliative care">Palliative care</a>, care aimed at improving the quality of life of people with major illness, has been recommended as part of management programs for metastasis.<sup id="cite_ref-Irwin_2013_38-0" class="reference"><a href="#cite_note-Irwin_2013-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup> Results from a systematic review of the literature on radiation therapy for brain metastases found that there is little evidence to inform <a href="/wiki/Comparative_effectiveness_research" title="Comparative effectiveness research">comparative effectiveness</a> and <a href="/wiki/Patient-centered_outcomes" title="Patient-centered outcomes">patient-centered</a> outcomes on quality of life, functional status, and cognitive effects.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=13" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Although metastasis is widely accepted to be the result of the tumor cells migration, there is a <a href="/wiki/Hypothesis" title="Hypothesis">hypothesis</a> saying that some metastases are the result of inflammatory processes by abnormal immune cells.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup> The existence of metastatic cancers in the absence of primary tumors also suggests that metastasis is not always caused by malignant cells that leave primary tumors.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>The research done by Sarna's team proved that heavily pigmented <a href="/wiki/Melanoma" title="Melanoma">melanoma</a> cells have <a href="/wiki/Young%27s_modulus" title="Young's modulus">Young's modulus</a> about 4.93, when in non-pigmented ones it was only 0.98.<sup id="cite_ref-Sarna_2019_42-0" class="reference"><a href="#cite_note-Sarna_2019-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> In another experiment they found that <a href="/wiki/Elasticity_(physics)" title="Elasticity (physics)">elasticity</a> of melanoma cells is important for its metastasis and growth: non-pigmented tumors were bigger than pigmented and it was much easier for them to spread. They showed that there are both pigmented and non-pigmented cells in melanoma <a href="/wiki/Neoplasm" title="Neoplasm">tumors</a>, so that they can both be <a href="/wiki/Drug_resistance" title="Drug resistance">drug-resistant</a> and metastatic.<sup id="cite_ref-Sarna_2019_42-1" class="reference"><a href="#cite_note-Sarna_2019-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=14" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The first physician to report the possibility of local metastasis from a primary cancerous source to nearby tissues was <a href="/wiki/Avicenna" title="Avicenna">Ibn Sina</a>. He described a case of breast cancer and metastatic condition in <a href="/wiki/The_Canon_of_Medicine" title="The Canon of Medicine">The Canon of Medicine</a>. His hypothesis was based on clinical course of the patient.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">[</span>44<span class="cite-bracket">]</span></a></sup> </p><p>In March 2014 researchers discovered the oldest complete example of a human with metastatic cancer. The tumors had developed in a 3,000-year-old skeleton found in 2013 in a tomb in <a href="/wiki/Sudan" title="Sudan">Sudan</a> dating back to 1200 BC. The skeleton was analyzed using radiography and a scanning electron microscope. These findings were published in the <i><a href="/wiki/Public_Library_of_Science" class="mw-redirect" title="Public Library of Science">Public Library of Science</a></i> journal.<sup id="cite_ref-Kelland-cancer_45-0" class="reference"><a href="#cite_note-Kelland-cancer-45"><span class="cite-bracket">[</span>45<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ghosh-cancer_46-0" class="reference"><a href="#cite_note-Ghosh-cancer-46"><span class="cite-bracket">[</span>46<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Ross-cancer_47-0" class="reference"><a href="#cite_note-Ross-cancer-47"><span class="cite-bracket">[</span>47<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Etymology">Etymology</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=15" title="Edit section: Etymology"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Metastasis is an <a href="/wiki/Ancient_Greek" title="Ancient Greek">Ancient Greek</a> word (μετάστασις) meaning "displacement", from μετά, <i>meta</i>, "next", and στάσις, <i>stasis</i>, "placement". </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=16" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1266661725">.mw-parser-output .portalbox{padding:0;margin:0.5em 0;display:table;box-sizing:border-box;max-width:175px;list-style:none}.mw-parser-output .portalborder{border:1px solid var(--border-color-base,#a2a9b1);padding:0.1em;background:var(--background-color-neutral-subtle,#f8f9fa)}.mw-parser-output .portalbox-entry{display:table-row;font-size:85%;line-height:110%;height:1.9em;font-style:italic;font-weight:bold}.mw-parser-output .portalbox-image{display:table-cell;padding:0.2em;vertical-align:middle;text-align:center}.mw-parser-output .portalbox-link{display:table-cell;padding:0.2em 0.2em 0.2em 0.3em;vertical-align:middle}@media(min-width:720px){.mw-parser-output .portalleft{margin:0.5em 1em 0.5em 0}.mw-parser-output .portalright{clear:right;float:right;margin:0.5em 0 0.5em 1em}}</style><ul role="navigation" aria-label="Portals" class="noprint portalbox portalborder portalright"> <li class="portalbox-entry"><span class="portalbox-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Issoria_lathonia.jpg" class="mw-file-description"><img alt="icon" src="//upload.wikimedia.org/wikipedia/commons/thumb/2/2d/Issoria_lathonia.jpg/32px-Issoria_lathonia.jpg" decoding="async" width="32" height="23" class="mw-file-element" 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tomography">Positron emission tomography</a> (PET)</li> <li><a href="/wiki/Urogenital_pelvic_malignancy" title="Urogenital pelvic malignancy">Urogenital pelvic malignancy</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=17" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns 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a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.merriam-webster.com/dictionary/metastasis">"Metastasis"</a>. <i>Merriam–Webster online</i><span class="reference-accessdate">. Retrieved <span class="nowrap">20 August</span> 2017</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Merriam%E2%80%93Webster+online&rft.atitle=Metastasis&rft_id=https%3A%2F%2Fwww.merriam-webster.com%2Fdictionary%2Fmetastasis&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-cancernet-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-cancernet_2-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.cancer.net/navigating-cancer-care/cancer-basics/what-metastasis">"What is Metastasis?"</a>. <i>Cancer.Net</i>. American Cancer Society, Inc. 2 February 2016.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Cancer.Net&rft.atitle=What+is+Metastasis%3F&rft.date=2016-02-02&rft_id=http%3A%2F%2Fwww.cancer.net%2Fnavigating-cancer-care%2Fcancer-basics%2Fwhat-metastasis&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKlein2008" class="citation journal cs1">Klein CA (September 2008). "Cancer. The metastasis cascade". <i>Science</i>. <b>321</b> (5897): <span class="nowrap">1785–</span>1787. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1126%2Fscience.1164853">10.1126/science.1164853</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18818347">18818347</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:206515808">206515808</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Science&rft.atitle=Cancer.+The+metastasis+cascade&rft.volume=321&rft.issue=5897&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1785-%3C%2Fspan%3E1787&rft.date=2008-09&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A206515808%23id-name%3DS2CID&rft_id=info%3Apmid%2F18818347&rft_id=info%3Adoi%2F10.1126%2Fscience.1164853&rft.aulast=Klein&rft.aufirst=CA&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-4"><span class="mw-cite-backlink"><b><a href="#cite_ref-4">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFChiangMassagué2008" class="citation journal cs1">Chiang AC, <a href="/wiki/Joan_Massagu%C3%A9" title="Joan Massagué">Massagué J</a> (December 2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189180">"Molecular basis of metastasis"</a>. <i>The New England Journal of Medicine</i>. <b>359</b> (26): <span class="nowrap">2814–</span>2823. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMra0805239">10.1056/NEJMra0805239</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189180">4189180</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19109576">19109576</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=Molecular+basis+of+metastasis&rft.volume=359&rft.issue=26&rft.pages=%3Cspan+class%3D%22nowrap%22%3E2814-%3C%2Fspan%3E2823&rft.date=2008-12&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4189180%23id-name%3DPMC&rft_id=info%3Apmid%2F19109576&rft_id=info%3Adoi%2F10.1056%2FNEJMra0805239&rft.aulast=Chiang&rft.aufirst=AC&rft.au=Massagu%C3%A9%2C+J&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4189180&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20170220115214/http://edcan.org.au/edcan-learning-resources/supporting-resources/biology-of-cancer/defining-cancer/invasion-metastasis">"Invasion and metastasis"</a>. <i><a href="/wiki/Cancer_Australia" title="Cancer Australia">Cancer Australia</a></i>. Australian Government. 2014-12-16. Archived from <a rel="nofollow" class="external text" href="http://edcan.org.au/edcan-learning-resources/supporting-resources/biology-of-cancer/defining-cancer/invasion-metastasis">the original</a> on 20 February 2017<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-10-26</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Cancer+Australia&rft.atitle=Invasion+and+metastasis&rft.date=2014-12-16&rft_id=http%3A%2F%2Fedcan.org.au%2Fedcan-learning-resources%2Fsupporting-resources%2Fbiology-of-cancer%2Fdefining-cancer%2Finvasion-metastasis&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMaheswaranHaber2010" class="citation journal cs1">Maheswaran S, <a href="/wiki/Daniel_A._Haber" title="Daniel A. Haber">Haber DA</a> (February 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846729">"Circulating tumor cells: a window into cancer biology and metastasis"</a>. <i>Current Opinion in Genetics & Development</i>. <b>20</b> (1): <span class="nowrap">96–</span>99. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.gde.2009.12.002">10.1016/j.gde.2009.12.002</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846729">2846729</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20071161">20071161</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Current+Opinion+in+Genetics+%26+Development&rft.atitle=Circulating+tumor+cells%3A+a+window+into+cancer+biology+and+metastasis&rft.volume=20&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E96-%3C%2Fspan%3E99&rft.date=2010-02&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2846729%23id-name%3DPMC&rft_id=info%3Apmid%2F20071161&rft_id=info%3Adoi%2F10.1016%2Fj.gde.2009.12.002&rft.aulast=Maheswaran&rft.aufirst=S&rft.au=Haber%2C+DA&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2846729&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Aceto-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-Aceto_7-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAcetoBardiaMiyamotoDonaldson2014" class="citation journal cs1">Aceto N, Bardia A, Miyamoto DT, Donaldson MC, Wittner BS, Spencer JA, et al. (August 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149753">"Circulating tumor cell clusters are oligoclonal precursors of breast cancer metastasis"</a>. <i>Cell</i>. <b>158</b> (5): <span class="nowrap">1110–</span>1122. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.cell.2014.07.013">10.1016/j.cell.2014.07.013</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4149753">4149753</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25171411">25171411</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cell&rft.atitle=Circulating+tumor+cell+clusters+are+oligoclonal+precursors+of+breast+cancer+metastasis&rft.volume=158&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1110-%3C%2Fspan%3E1122&rft.date=2014-08&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4149753%23id-name%3DPMC&rft_id=info%3Apmid%2F25171411&rft_id=info%3Adoi%2F10.1016%2Fj.cell.2014.07.013&rft.aulast=Aceto&rft.aufirst=N&rft.au=Bardia%2C+A&rft.au=Miyamoto%2C+DT&rft.au=Donaldson%2C+MC&rft.au=Wittner%2C+BS&rft.au=Spencer%2C+JA&rft.au=Yu%2C+M&rft.au=Pely%2C+A&rft.au=Engstrom%2C+A&rft.au=Zhu%2C+H&rft.au=Brannigan%2C+BW&rft.au=Kapur%2C+R&rft.au=Stott%2C+SL&rft.au=Shioda%2C+T&rft.au=Ramaswamy%2C+S&rft.au=Ting%2C+DT&rft.au=Lin%2C+CP&rft.au=Toner%2C+M&rft.au=Haber%2C+DA&rft.au=Maheswaran%2C+S&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4149753&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Robbins-8"><span class="mw-cite-backlink">^ <a href="#cite_ref-Robbins_8-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Robbins_8-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Robbins_8-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Robbins_8-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKumarAbbasFaustoRobbins2005" class="citation book cs1">Kumar V, Abbas AK, Fausto N, Robbins SL, Cotran RS (2005). <i>Robbins and Cotran pathologic basis of disease</i> (7th ed.). Philadelphia: Elsevier Saunders. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-7216-0187-8" title="Special:BookSources/978-0-7216-0187-8"><bdi>978-0-7216-0187-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Robbins+and+Cotran+pathologic+basis+of+disease&rft.place=Philadelphia&rft.edition=7th&rft.pub=Elsevier+Saunders&rft.date=2005&rft.isbn=978-0-7216-0187-8&rft.aulast=Kumar&rft.aufirst=V&rft.au=Abbas%2C+AK&rft.au=Fausto%2C+N&rft.au=Robbins%2C+SL&rft.au=Cotran%2C+RS&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAdes2018" class="citation news cs1 cs1-prop-foreign-lang-source">Ades F (2018-07-24). <a rel="nofollow" class="external text" href="http://drfelipeades.com/2018/07/24/o-que-e-a-metastase/">"O que é a metástase?"</a> [What is metastasis?]. <i>drfelipeades.com</i> (in Brazilian Portuguese)<span class="reference-accessdate">. Retrieved <span class="nowrap">2018-10-23</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=drfelipeades.com&rft.atitle=O+que+%C3%A9+a+met%C3%A1stase%3F&rft.date=2018-07-24&rft.aulast=Ades&rft.aufirst=F&rft_id=http%3A%2F%2Fdrfelipeades.com%2F2018%2F07%2F24%2Fo-que-e-a-metastase%2F&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-nci-10"><span class="mw-cite-backlink">^ <a href="#cite_ref-nci_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-nci_10-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-nci_10-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-nci_10-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-nci_10-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-nci_10-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-nci_10-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-nci_10-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-nci_10-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-nci_10-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-nci_10-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-nci_10-11"><sup><i><b>l</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic">"Metastatic Cancer: Questions and Answers"</a>. <i>National Cancer Institute</i>. U.S. National Institutes of Health<span class="reference-accessdate">. Retrieved <span class="nowrap">2008-11-01</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=National+Cancer+Institute&rft.atitle=Metastatic+Cancer%3A+Questions+and+Answers&rft_id=http%3A%2F%2Fwww.cancer.gov%2Fcancertopics%2Ffactsheet%2FSites-Types%2Fmetastatic&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Olteanu_2020-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-Olteanu_2020_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Olteanu_2020_11-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFOlteanuMihaiBojinGavriliuc2020" class="citation journal cs1">Olteanu GE, Mihai IM, Bojin F, Gavriliuc O, Paunescu V (August 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416172">"The natural adaptive evolution of cancer: The metastatic ability of cancer cells"</a>. <i>Bosnian Journal of Basic Medical Sciences</i>. <b>20</b> (3): <span class="nowrap">303–</span>309. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.17305%2Fbjbms.2019.4565">10.17305/bjbms.2019.4565</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416172">7416172</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32020846">32020846</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Bosnian+Journal+of+Basic+Medical+Sciences&rft.atitle=The+natural+adaptive+evolution+of+cancer%3A+The+metastatic+ability+of+cancer+cells&rft.volume=20&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E303-%3C%2Fspan%3E309&rft.date=2020-08&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7416172%23id-name%3DPMC&rft_id=info%3Apmid%2F32020846&rft_id=info%3Adoi%2F10.17305%2Fbjbms.2019.4565&rft.aulast=Olteanu&rft.aufirst=GE&rft.au=Mihai%2C+IM&rft.au=Bojin%2C+F&rft.au=Gavriliuc%2C+O&rft.au=Paunescu%2C+V&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC7416172&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Nguyen_2007-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-Nguyen_2007_12-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNguyenMassagué2007" class="citation journal cs1">Nguyen DX, <a href="/wiki/Joan_Massagu%C3%A9" title="Joan Massagué">Massagué J</a> (May 2007). "Genetic determinants of cancer metastasis". <i>Nature Reviews. Genetics</i>. <b>8</b> (5): <span class="nowrap">341–</span>352. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnrg2101">10.1038/nrg2101</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17440531">17440531</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:17745552">17745552</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews.+Genetics&rft.atitle=Genetic+determinants+of+cancer+metastasis&rft.volume=8&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E341-%3C%2Fspan%3E352&rft.date=2007-05&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A17745552%23id-name%3DS2CID&rft_id=info%3Apmid%2F17440531&rft_id=info%3Adoi%2F10.1038%2Fnrg2101&rft.aulast=Nguyen&rft.aufirst=DX&rft.au=Massagu%C3%A9%2C+J&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Zlotnik_2011-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-Zlotnik_2011_13-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFZlotnikBurkhardtHomey2011" class="citation journal cs1">Zlotnik A, Burkhardt AM, Homey B (August 2011). "Homeostatic chemokine receptors and organ-specific metastasis". <i>Nature Reviews. Immunology</i>. <b>11</b> (9): <span class="nowrap">597–</span>606. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnri3049">10.1038/nri3049</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21866172">21866172</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:34438005">34438005</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews.+Immunology&rft.atitle=Homeostatic+chemokine+receptors+and+organ-specific+metastasis&rft.volume=11&rft.issue=9&rft.pages=%3Cspan+class%3D%22nowrap%22%3E597-%3C%2Fspan%3E606&rft.date=2011-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A34438005%23id-name%3DS2CID&rft_id=info%3Apmid%2F21866172&rft_id=info%3Adoi%2F10.1038%2Fnri3049&rft.aulast=Zlotnik&rft.aufirst=A&rft.au=Burkhardt%2C+AM&rft.au=Homey%2C+B&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Drabsch_2011-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-Drabsch_2011_14-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFDrabschten_Dijke2011" class="citation journal cs1">Drabsch Y, ten Dijke P (June 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095797">"TGF-β signaling in breast cancer cell invasion and bone metastasis"</a>. <i>Journal of Mammary Gland Biology and Neoplasia</i>. <b>16</b> (2): <span class="nowrap">97–</span>108. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs10911-011-9217-1">10.1007/s10911-011-9217-1</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3095797">3095797</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21494783">21494783</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+Mammary+Gland+Biology+and+Neoplasia&rft.atitle=TGF-%CE%B2+signaling+in+breast+cancer+cell+invasion+and+bone+metastasis&rft.volume=16&rft.issue=2&rft.pages=%3Cspan+class%3D%22nowrap%22%3E97-%3C%2Fspan%3E108&rft.date=2011-06&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3095797%23id-name%3DPMC&rft_id=info%3Apmid%2F21494783&rft_id=info%3Adoi%2F10.1007%2Fs10911-011-9217-1&rft.aulast=Drabsch&rft.aufirst=Y&rft.au=ten+Dijke%2C+P&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3095797&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-15"><span class="mw-cite-backlink"><b><a href="#cite_ref-15">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFYoshidaSokoloffWelchRinker-Schaeffer2000" class="citation journal cs1">Yoshida BA, Sokoloff MM, <a href="/wiki/Danny_Welch" title="Danny Welch">Welch DR</a>, Rinker-Schaeffer CW (November 2000). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjnci%2F92.21.1717">"Metastasis-suppressor genes: a review and perspective on an emerging field"</a>. <i>Journal of the National Cancer Institute</i>. <b>92</b> (21): <span class="nowrap">1717–</span>1730. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fjnci%2F92.21.1717">10.1093/jnci/92.21.1717</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11058615">11058615</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+National+Cancer+Institute&rft.atitle=Metastasis-suppressor+genes%3A+a+review+and+perspective+on+an+emerging+field&rft.volume=92&rft.issue=21&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1717-%3C%2Fspan%3E1730&rft.date=2000-11&rft_id=info%3Adoi%2F10.1093%2Fjnci%2F92.21.1717&rft_id=info%3Apmid%2F11058615&rft.aulast=Yoshida&rft.aufirst=BA&rft.au=Sokoloff%2C+MM&rft.au=Welch%2C+DR&rft.au=Rinker-Schaeffer%2C+CW&rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fjnci%252F92.21.1717&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-16"><span class="mw-cite-backlink"><b><a href="#cite_ref-16">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFParriChiarugi2010" class="citation journal cs1">Parri M, Chiarugi P (September 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941746">"Rac and Rho GTPases in cancer cell motility control"</a>. <i>Cell Communication and Signaling</i>. <b>8</b> (1): 23. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1186%2F1478-811X-8-23">10.1186/1478-811X-8-23</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941746">2941746</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20822528">20822528</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cell+Communication+and+Signaling&rft.atitle=Rac+and+Rho+GTPases+in+cancer+cell+motility+control&rft.volume=8&rft.issue=1&rft.pages=23&rft.date=2010-09&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2941746%23id-name%3DPMC&rft_id=info%3Apmid%2F20822528&rft_id=info%3Adoi%2F10.1186%2F1478-811X-8-23&rft.aulast=Parri&rft.aufirst=M&rft.au=Chiarugi%2C+P&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC2941746&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-17">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFriedlWolf2003" class="citation journal cs1">Friedl P, Wolf K (May 2003). "Tumour-cell invasion and migration: diversity and escape mechanisms". <i>Nature Reviews. Cancer</i>. <b>3</b> (5): <span class="nowrap">362–</span>374. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnrc1075">10.1038/nrc1075</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12724734">12724734</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:5547981">5547981</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews.+Cancer&rft.atitle=Tumour-cell+invasion+and+migration%3A+diversity+and+escape+mechanisms&rft.volume=3&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E362-%3C%2Fspan%3E374&rft.date=2003-05&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A5547981%23id-name%3DS2CID&rft_id=info%3Apmid%2F12724734&rft_id=info%3Adoi%2F10.1038%2Fnrc1075&rft.aulast=Friedl&rft.aufirst=P&rft.au=Wolf%2C+K&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFEscribanoChenMoeendarbaryCao2019" class="citation journal cs1">Escribano J, Chen MB, Moeendarbary E, Cao X, Shenoy V, Garcia-Aznar JM, et al. (May 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497229">"Balance of mechanical forces drives endothelial gap formation and may facilitate cancer and immune-cell extravasation"</a>. <i>PLOS Computational Biology</i>. <b>15</b> (5): e1006395. <a href="/wiki/ArXiv_(identifier)" class="mw-redirect" title="ArXiv (identifier)">arXiv</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://arxiv.org/abs/1811.09326">1811.09326</a></span>. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2019PLSCB..15E6395E">2019PLSCB..15E6395E</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pcbi.1006395">10.1371/journal.pcbi.1006395</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6497229">6497229</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31048903">31048903</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=PLOS+Computational+Biology&rft.atitle=Balance+of+mechanical+forces+drives+endothelial+gap+formation+and+may+facilitate+cancer+and+immune-cell+extravasation&rft.volume=15&rft.issue=5&rft.pages=e1006395&rft.date=2019-05&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6497229%23id-name%3DPMC&rft_id=info%3Abibcode%2F2019PLSCB..15E6395E&rft_id=info%3Aarxiv%2F1811.09326&rft_id=info%3Apmid%2F31048903&rft_id=info%3Adoi%2F10.1371%2Fjournal.pcbi.1006395&rft.aulast=Escribano&rft.aufirst=J&rft.au=Chen%2C+MB&rft.au=Moeendarbary%2C+E&rft.au=Cao%2C+X&rft.au=Shenoy%2C+V&rft.au=Garcia-Aznar%2C+JM&rft.au=Kamm%2C+RD&rft.au=Spill%2C+F&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6497229&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-19"><span class="mw-cite-backlink"><b><a href="#cite_ref-19">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWeidnerSempleWelchFolkman1991" class="citation journal cs1">Weidner N, Semple JP, Welch WR, Folkman J (January 1991). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJM199101033240101">"Tumor angiogenesis and metastasis--correlation in invasive breast carcinoma"</a>. <i>The New England Journal of Medicine</i>. <b>324</b> (1): <span class="nowrap">1–</span>8. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJM199101033240101">10.1056/NEJM199101033240101</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/1701519">1701519</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+England+Journal+of+Medicine&rft.atitle=Tumor+angiogenesis+and+metastasis--correlation+in+invasive+breast+carcinoma&rft.volume=324&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1-%3C%2Fspan%3E8&rft.date=1991-01&rft_id=info%3Adoi%2F10.1056%2FNEJM199101033240101&rft_id=info%3Apmid%2F1701519&rft.aulast=Weidner&rft.aufirst=N&rft.au=Semple%2C+JP&rft.au=Welch%2C+WR&rft.au=Folkman%2C+J&rft_id=https%3A%2F%2Fdoi.org%2F10.1056%252FNEJM199101033240101&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-pmid18187653-20"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid18187653_20-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGaoNolanMellickBambino2008" class="citation journal cs1">Gao D, Nolan DJ, Mellick AS, Bambino K, McDonnell K, Mittal V (January 2008). "Endothelial progenitor cells control the angiogenic switch in mouse lung metastasis". <i>Science</i>. <b>319</b> (5860): <span class="nowrap">195–</span>198. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2008Sci...319..195G">2008Sci...319..195G</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1126%2Fscience.1150224">10.1126/science.1150224</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18187653">18187653</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:12577022">12577022</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Science&rft.atitle=Endothelial+progenitor+cells+control+the+angiogenic+switch+in+mouse+lung+metastasis&rft.volume=319&rft.issue=5860&rft.pages=%3Cspan+class%3D%22nowrap%22%3E195-%3C%2Fspan%3E198&rft.date=2008-01&rft_id=info%3Adoi%2F10.1126%2Fscience.1150224&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A12577022%23id-name%3DS2CID&rft_id=info%3Apmid%2F18187653&rft_id=info%3Abibcode%2F2008Sci...319..195G&rft.aulast=Gao&rft.aufirst=D&rft.au=Nolan%2C+DJ&rft.au=Mellick%2C+AS&rft.au=Bambino%2C+K&rft.au=McDonnell%2C+K&rft.au=Mittal%2C+V&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-pmid17575055-21"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid17575055_21-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNolanCiarrocchiMellickJaggi2007" class="citation journal cs1">Nolan DJ, Ciarrocchi A, Mellick AS, Jaggi JS, Bambino K, Gupta S, et al. (June 2007). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891431">"Bone marrow-derived endothelial progenitor cells are a major determinant of nascent tumor neovascularization"</a>. <i>Genes & Development</i>. <b>21</b> (12): <span class="nowrap">1546–</span>1558. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1101%2Fgad.436307">10.1101/gad.436307</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1891431">1891431</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17575055">17575055</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Genes+%26+Development&rft.atitle=Bone+marrow-derived+endothelial+progenitor+cells+are+a+major+determinant+of+nascent+tumor+neovascularization&rft.volume=21&rft.issue=12&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1546-%3C%2Fspan%3E1558&rft.date=2007-06&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1891431%23id-name%3DPMC&rft_id=info%3Apmid%2F17575055&rft_id=info%3Adoi%2F10.1101%2Fgad.436307&rft.aulast=Nolan&rft.aufirst=DJ&rft.au=Ciarrocchi%2C+A&rft.au=Mellick%2C+AS&rft.au=Jaggi%2C+JS&rft.au=Bambino%2C+K&rft.au=Gupta%2C+S&rft.au=Heikamp%2C+E&rft.au=McDevitt%2C+MR&rft.au=Scheinberg%2C+DA&rft.au=Benezra%2C+R&rft.au=Mittal%2C+V&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC1891431&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-22"><span class="mw-cite-backlink"><b><a href="#cite_ref-22">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMellickPlummerNolanGao2010" class="citation journal cs1">Mellick AS, Plummer PN, Nolan DJ, Gao D, Bambino K, Hahn M, et al. (September 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058751">"Using the transcription factor inhibitor of DNA binding 1 to selectively target endothelial progenitor cells offers novel strategies to inhibit tumor angiogenesis and growth"</a>. <i>Cancer Research</i>. <b>70</b> (18): <span class="nowrap">7273–</span>7282. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1158%2F0008-5472.CAN-10-1142">10.1158/0008-5472.CAN-10-1142</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3058751">3058751</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20807818">20807818</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cancer+Research&rft.atitle=Using+the+transcription+factor+inhibitor+of+DNA+binding+1+to+selectively+target+endothelial+progenitor+cells+offers+novel+strategies+to+inhibit+tumor+angiogenesis+and+growth&rft.volume=70&rft.issue=18&rft.pages=%3Cspan+class%3D%22nowrap%22%3E7273-%3C%2Fspan%3E7282&rft.date=2010-09&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3058751%23id-name%3DPMC&rft_id=info%3Apmid%2F20807818&rft_id=info%3Adoi%2F10.1158%2F0008-5472.CAN-10-1142&rft.aulast=Mellick&rft.aufirst=AS&rft.au=Plummer%2C+PN&rft.au=Nolan%2C+DJ&rft.au=Gao%2C+D&rft.au=Bambino%2C+K&rft.au=Hahn%2C+M&rft.au=Catena%2C+R&rft.au=Turner%2C+V&rft.au=McDonnell%2C+K&rft.au=Benezra%2C+R&rft.au=Brink%2C+R&rft.au=Swarbrick%2C+A&rft.au=Mittal%2C+V&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3058751&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-23"><span class="mw-cite-backlink"><b><a href="#cite_ref-23">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFFranciZhouJiangModrusan2013" class="citation journal cs1">Franci C, Zhou J, Jiang Z, Modrusan Z, Good Z, Jackson E, et al. (2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592916">"Biomarkers of residual disease, disseminated tumor cells, and metastases in the MMTV-PyMT breast cancer model"</a>. <i>PLOS ONE</i>. <b>8</b> (3): e58183. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2013PLoSO...858183F">2013PLoSO...858183F</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pone.0058183">10.1371/journal.pone.0058183</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592916">3592916</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23520493">23520493</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=PLOS+ONE&rft.atitle=Biomarkers+of+residual+disease%2C+disseminated+tumor+cells%2C+and+metastases+in+the+MMTV-PyMT+breast+cancer+model&rft.volume=8&rft.issue=3&rft.pages=e58183&rft.date=2013&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3592916%23id-name%3DPMC&rft_id=info%3Apmid%2F23520493&rft_id=info%3Adoi%2F10.1371%2Fjournal.pone.0058183&rft_id=info%3Abibcode%2F2013PLoSO...858183F&rft.aulast=Franci&rft.aufirst=C&rft.au=Zhou%2C+J&rft.au=Jiang%2C+Z&rft.au=Modrusan%2C+Z&rft.au=Good%2C+Z&rft.au=Jackson%2C+E&rft.au=Kouros-Mehr%2C+H&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC3592916&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-24"><span class="mw-cite-backlink"><b><a href="#cite_ref-24">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLujambioEsteller2009" class="citation journal cs1">Lujambio A, Esteller M (February 2009). <a rel="nofollow" class="external text" href="https://doi.org/10.4161%2Fcc.8.3.7526">"How epigenetics can explain human metastasis: a new role for microRNAs"</a>. <i>Cell Cycle</i>. <b>8</b> (3): <span class="nowrap">377–</span>382. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.4161%2Fcc.8.3.7526">10.4161/cc.8.3.7526</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19177007">19177007</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cell+Cycle&rft.atitle=How+epigenetics+can+explain+human+metastasis%3A+a+new+role+for+microRNAs&rft.volume=8&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E377-%3C%2Fspan%3E382&rft.date=2009-02&rft_id=info%3Adoi%2F10.4161%2Fcc.8.3.7526&rft_id=info%3Apmid%2F19177007&rft.aulast=Lujambio&rft.aufirst=A&rft.au=Esteller%2C+M&rft_id=https%3A%2F%2Fdoi.org%2F10.4161%252Fcc.8.3.7526&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-pmid29048609-25"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid29048609_25-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRatnayakeApostolatosOstrovAcevedo-Duncan2017" class="citation journal cs1">Ratnayake WS, Apostolatos AH, Ostrov DA, Acevedo-Duncan M (November 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642393">"Two novel atypical PKC inhibitors; ACPD and DNDA effectively mitigate cell proliferation and epithelial to mesenchymal transition of metastatic melanoma while inducing apoptosis"</a>. <i>International Journal of Oncology</i>. <b>51</b> (5): <span class="nowrap">1370–</span>1382. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3892%2Fijo.2017.4131">10.3892/ijo.2017.4131</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5642393">5642393</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29048609">29048609</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=International+Journal+of+Oncology&rft.atitle=Two+novel+atypical+PKC+inhibitors%3B+ACPD+and+DNDA+effectively+mitigate+cell+proliferation+and+epithelial+to+mesenchymal+transition+of+metastatic+melanoma+while+inducing+apoptosis&rft.volume=51&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1370-%3C%2Fspan%3E1382&rft.date=2017-11&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5642393%23id-name%3DPMC&rft_id=info%3Apmid%2F29048609&rft_id=info%3Adoi%2F10.3892%2Fijo.2017.4131&rft.aulast=Ratnayake&rft.aufirst=WS&rft.au=Apostolatos%2C+AH&rft.au=Ostrov%2C+DA&rft.au=Acevedo-Duncan%2C+M&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5642393&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Syn_2016-26"><span class="mw-cite-backlink">^ <a href="#cite_ref-Syn_2016_26-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Syn_2016_26-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Syn_2016_26-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSynWangSethiThiery2016" class="citation journal cs1">Syn N, Wang L, Sethi G, Thiery JP, Goh BC (July 2016). "Exosome-Mediated Metastasis: From Epithelial-Mesenchymal Transition to Escape from Immunosurveillance". <i>Trends in Pharmacological Sciences</i>. <b>37</b> (7): <span class="nowrap">606–</span>617. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.tips.2016.04.006">10.1016/j.tips.2016.04.006</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27157716">27157716</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Trends+in+Pharmacological+Sciences&rft.atitle=Exosome-Mediated+Metastasis%3A+From+Epithelial-Mesenchymal+Transition+to+Escape+from+Immunosurveillance&rft.volume=37&rft.issue=7&rft.pages=%3Cspan+class%3D%22nowrap%22%3E606-%3C%2Fspan%3E617&rft.date=2016-07&rft_id=info%3Adoi%2F10.1016%2Fj.tips.2016.04.006&rft_id=info%3Apmid%2F27157716&rft.aulast=Syn&rft.aufirst=N&rft.au=Wang%2C+L&rft.au=Sethi%2C+G&rft.au=Thiery%2C+JP&rft.au=Goh%2C+BC&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text">List of included entries and references is found on main image page in Commons: <a href="https://commons.wikimedia.org/wiki/File:Metastasis_sites_for_common_cancers.svg#Summary" class="extiw" title="commons:File:Metastasis sites for common cancers.svg">Commons:File:Metastasis sites for common cancers.svg#Summary</a></span> </li> <li id="cite_note-28"><span class="mw-cite-backlink"><b><a href="#cite_ref-28">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRibattiMangialardiVacca2006" class="citation journal cs1">Ribatti D, Mangialardi G, Vacca A (December 2006). "Stephen Paget and the 'seed and soil' theory of metastatic dissemination". <i>Clinical and Experimental Medicine</i>. <b>6</b> (4): <span class="nowrap">145–</span>149. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs10238-006-0117-4">10.1007/s10238-006-0117-4</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17191105">17191105</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:26736196">26736196</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Clinical+and+Experimental+Medicine&rft.atitle=Stephen+Paget+and+the+%27seed+and+soil%27+theory+of+metastatic+dissemination&rft.volume=6&rft.issue=4&rft.pages=%3Cspan+class%3D%22nowrap%22%3E145-%3C%2Fspan%3E149&rft.date=2006-12&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A26736196%23id-name%3DS2CID&rft_id=info%3Apmid%2F17191105&rft_id=info%3Adoi%2F10.1007%2Fs10238-006-0117-4&rft.aulast=Ribatti&rft.aufirst=D&rft.au=Mangialardi%2C+G&rft.au=Vacca%2C+A&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Hart_1982-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-Hart_1982_29-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHart1982" class="citation journal cs1">Hart IR (1982). "<span class="cs1-kern-left"></span>'Seed and soil' revisited: mechanisms of site-specific metastasis". <i>Cancer and Metastasis Reviews</i>. <b>1</b> (1): <span class="nowrap">5–</span>16. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2FBF00049477">10.1007/BF00049477</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/6764375">6764375</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:19573769">19573769</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cancer+and+Metastasis+Reviews&rft.atitle=%27Seed+and+soil%27+revisited%3A+mechanisms+of+site-specific+metastasis&rft.volume=1&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E5-%3C%2Fspan%3E16&rft.date=1982&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A19573769%23id-name%3DS2CID&rft_id=info%3Apmid%2F6764375&rft_id=info%3Adoi%2F10.1007%2FBF00049477&rft.aulast=Hart&rft.aufirst=IR&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWeinberg2007" class="citation book cs1">Weinberg RA (2007). <i>The Biology of Cancer</i>. New York: Taylor & Francis. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-8153-4076-8" title="Special:BookSources/978-0-8153-4076-8"><bdi>978-0-8153-4076-8</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+Biology+of+Cancer&rft.place=New+York&rft.pub=Taylor+%26+Francis&rft.date=2007&rft.isbn=978-0-8153-4076-8&rft.aulast=Weinberg&rft.aufirst=RA&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span> quoted in <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAngier2007" class="citation news cs1">Angier N (3 April 2007). <a rel="nofollow" class="external text" href="https://www.nytimes.com/2007/04/03/health/03angi.html">"Basics: A mutinous group of cells on a greedy, destructive task"</a>. <i><a href="/wiki/The_New_York_Times" title="The New York Times">The New York Times</a></i>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+New+York+Times&rft.atitle=Basics%3A+A+mutinous+group+of+cells+on+a+greedy%2C+destructive+task&rft.date=2007-04-03&rft.aulast=Angier&rft.aufirst=N&rft_id=https%3A%2F%2Fwww.nytimes.com%2F2007%2F04%2F03%2Fhealth%2F03angi.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-filterflow-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-filterflow_31-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFScottKuhnAnderson2012" class="citation journal cs1">Scott J, Kuhn P, Anderson AR (July 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533867">"Unifying metastasis--integrating intravasation, circulation and end-organ colonization"</a>. <i>Nature Reviews. Cancer</i>. <b>12</b> (7): <span class="nowrap">445–</span>446. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnrc3287">10.1038/nrc3287</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533867">4533867</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22912952">22912952</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Reviews.+Cancer&rft.atitle=Unifying+metastasis--integrating+intravasation%2C+circulation+and+end-organ+colonization&rft.volume=12&rft.issue=7&rft.pages=%3Cspan+class%3D%22nowrap%22%3E445-%3C%2Fspan%3E446&rft.date=2012-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4533867%23id-name%3DPMC&rft_id=info%3Apmid%2F22912952&rft_id=info%3Adoi%2F10.1038%2Fnrc3287&rft.aulast=Scott&rft.aufirst=J&rft.au=Kuhn%2C+P&rft.au=Anderson%2C+AR&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4533867&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFEttingerAgulnikCatesCristea2011" class="citation journal cs1">Ettinger DS, Agulnik M, Cates JM, Cristea M, Denlinger CS, Eaton KD, et al. (December 2011). <a rel="nofollow" class="external text" href="https://doi.org/10.6004%2Fjnccn.2011.0117">"NCCN Clinical Practice Guidelines Occult primary"</a>. <i>Journal of the National Comprehensive Cancer Network</i>. <b>9</b> (12): <span class="nowrap">1358–</span>1395. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.6004%2Fjnccn.2011.0117">10.6004/jnccn.2011.0117</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22157556">22157556</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Journal+of+the+National+Comprehensive+Cancer+Network&rft.atitle=NCCN+Clinical+Practice+Guidelines+Occult+primary&rft.volume=9&rft.issue=12&rft.pages=%3Cspan+class%3D%22nowrap%22%3E1358-%3C%2Fspan%3E1395&rft.date=2011-12&rft_id=info%3Adoi%2F10.6004%2Fjnccn.2011.0117&rft_id=info%3Apmid%2F22157556&rft.aulast=Ettinger&rft.aufirst=DS&rft.au=Agulnik%2C+M&rft.au=Cates%2C+JM&rft.au=Cristea%2C+M&rft.au=Denlinger%2C+CS&rft.au=Eaton%2C+KD&rft.au=Fidias%2C+PM&rft.au=Gierada%2C+D&rft.au=Gockerman%2C+JP&rft.au=Handorf%2C+CR&rft.au=Iyer%2C+R&rft.au=Lenzi%2C+R&rft.au=Phay%2C+J&rft.au=Rashid%2C+A&rft.au=Saltz%2C+L&rft.au=Shulman%2C+LN&rft.au=Smerage%2C+JB&rft.au=Varadhachary%2C+GR&rft.au=Zager%2C+JS&rft.au=Zhen%2C+WK&rft_id=https%3A%2F%2Fdoi.org%2F10.6004%252Fjnccn.2011.0117&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-CUP-Oncologist-33"><span class="mw-cite-backlink">^ <a href="#cite_ref-CUP-Oncologist_33-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-CUP-Oncologist_33-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBriasoulisPavlidis1997" class="citation journal cs1">Briasoulis E, Pavlidis N (1997). <a rel="nofollow" class="external text" href="https://doi.org/10.1634%2Ftheoncologist.2-3-142">"Cancer of Unknown Primary Origin"</a>. <i>The Oncologist</i>. <b>2</b> (3): <span class="nowrap">142–</span>152. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1634%2Ftheoncologist.2-3-142">10.1634/theoncologist.2-3-142</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10388044">10388044</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Oncologist&rft.atitle=Cancer+of+Unknown+Primary+Origin&rft.volume=2&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E142-%3C%2Fspan%3E152&rft.date=1997&rft_id=info%3Adoi%2F10.1634%2Ftheoncologist.2-3-142&rft_id=info%3Apmid%2F10388044&rft.aulast=Briasoulis&rft.aufirst=E&rft.au=Pavlidis%2C+N&rft_id=https%3A%2F%2Fdoi.org%2F10.1634%252Ftheoncologist.2-3-142&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-34"><span class="mw-cite-backlink"><b><a href="#cite_ref-34">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPosteFidler1980" class="citation journal cs1">Poste G, Fidler IJ (January 1980). "The pathogenesis of cancer metastasis". <i>Nature</i>. <b>283</b> (5743): <span class="nowrap">139–</span>146. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/1980Natur.283..139P">1980Natur.283..139P</a>. <a href="/wiki/CiteSeerX_(identifier)" class="mw-redirect" title="CiteSeerX (identifier)">CiteSeerX</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.553.5472">10.1.1.553.5472</a></span>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2F283139a0">10.1038/283139a0</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/6985715">6985715</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4302076">4302076</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature&rft.atitle=The+pathogenesis+of+cancer+metastasis&rft.volume=283&rft.issue=5743&rft.pages=%3Cspan+class%3D%22nowrap%22%3E139-%3C%2Fspan%3E146&rft.date=1980-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A4302076%23id-name%3DS2CID&rft_id=info%3Abibcode%2F1980Natur.283..139P&rft_id=https%3A%2F%2Fciteseerx.ist.psu.edu%2Fviewdoc%2Fsummary%3Fdoi%3D10.1.1.553.5472%23id-name%3DCiteSeerX&rft_id=info%3Apmid%2F6985715&rft_id=info%3Adoi%2F10.1038%2F283139a0&rft.aulast=Poste&rft.aufirst=G&rft.au=Fidler%2C+IJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-signature-35"><span class="mw-cite-backlink">^ <a href="#cite_ref-signature_35-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-signature_35-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-signature_35-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-signature_35-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-signature_35-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-signature_35-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRamaswamyRossLanderGolub2003" class="citation journal cs1">Ramaswamy S, Ross KN, Lander ES, Golub TR (January 2003). "A molecular signature of metastasis in primary solid tumors". <i>Nature Genetics</i>. <b>33</b> (1): <span class="nowrap">49–</span>54. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fng1060">10.1038/ng1060</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12469122">12469122</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:12059602">12059602</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature+Genetics&rft.atitle=A+molecular+signature+of+metastasis+in+primary+solid+tumors&rft.volume=33&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E49-%3C%2Fspan%3E54&rft.date=2003-01&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A12059602%23id-name%3DS2CID&rft_id=info%3Apmid%2F12469122&rft_id=info%3Adoi%2F10.1038%2Fng1060&rft.aulast=Ramaswamy&rft.aufirst=S&rft.au=Ross%2C+KN&rft.au=Lander%2C+ES&rft.au=Golub%2C+TR&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-36"><span class="mw-cite-backlink"><b><a href="#cite_ref-36">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFvan_'t_VeerDaivan_de_VijverHe2002" class="citation journal cs1"><a href="/wiki/Laura_J._van%27t_Veer" class="mw-redirect" title="Laura J. van't Veer">van 't Veer LJ</a>, Dai H, van de Vijver MJ, He YD, Hart AA, Mao M, et al. (January 2002). "Gene expression profiling predicts clinical outcome of breast cancer". <i>Nature</i>. <b>415</b> (6871): <span class="nowrap">530–</span>536. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2F415530a">10.1038/415530a</a>. <a href="/wiki/Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://hdl.handle.net/1874%2F15552">1874/15552</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11823860">11823860</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4369266">4369266</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature&rft.atitle=Gene+expression+profiling+predicts+clinical+outcome+of+breast+cancer&rft.volume=415&rft.issue=6871&rft.pages=%3Cspan+class%3D%22nowrap%22%3E530-%3C%2Fspan%3E536&rft.date=2002-01&rft_id=info%3Ahdl%2F1874%2F15552&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A4369266%23id-name%3DS2CID&rft_id=info%3Apmid%2F11823860&rft_id=info%3Adoi%2F10.1038%2F415530a&rft.aulast=van+%27t+Veer&rft.aufirst=LJ&rft.au=Dai%2C+H&rft.au=van+de+Vijver%2C+MJ&rft.au=He%2C+YD&rft.au=Hart%2C+AA&rft.au=Mao%2C+M&rft.au=Peterse%2C+HL&rft.au=van+der+Kooy%2C+K&rft.au=Marton%2C+MJ&rft.au=Witteveen%2C+AT&rft.au=Schreiber%2C+GJ&rft.au=Kerkhoven%2C+RM&rft.au=Roberts%2C+C&rft.au=Linsley%2C+PS&rft.au=Bernards%2C+R&rft.au=Friend%2C+SH&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-37"><span class="mw-cite-backlink"><b><a href="#cite_ref-37">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBakhoumNgoLaughneyCavallo2018" class="citation journal cs1">Bakhoum SF, Ngo B, Laughney AM, Cavallo JA, Murphy CJ, Ly P, et al. (January 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5785464">"Chromosomal instability drives metastasis through a cytosolic DNA response"</a>. <i>Nature</i>. <b>553</b> (7689): <span class="nowrap">467–</span>472. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2018Natur.553..467B">2018Natur.553..467B</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fnature25432">10.1038/nature25432</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5785464">5785464</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29342134">29342134</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Nature&rft.atitle=Chromosomal+instability+drives+metastasis+through+a+cytosolic+DNA+response&rft.volume=553&rft.issue=7689&rft.pages=%3Cspan+class%3D%22nowrap%22%3E467-%3C%2Fspan%3E472&rft.date=2018-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5785464%23id-name%3DPMC&rft_id=info%3Apmid%2F29342134&rft_id=info%3Adoi%2F10.1038%2Fnature25432&rft_id=info%3Abibcode%2F2018Natur.553..467B&rft.aulast=Bakhoum&rft.aufirst=SF&rft.au=Ngo%2C+B&rft.au=Laughney%2C+AM&rft.au=Cavallo%2C+JA&rft.au=Murphy%2C+CJ&rft.au=Ly%2C+P&rft.au=Shah%2C+P&rft.au=Sriram%2C+RK&rft.au=Watkins%2C+TB&rft.au=Taunk%2C+NK&rft.au=Duran%2C+M&rft.au=Pauli%2C+C&rft.au=Shaw%2C+C&rft.au=Chadalavada%2C+K&rft.au=Rajasekhar%2C+VK&rft.au=Genovese%2C+G&rft.au=Venkatesan%2C+S&rft.au=Birkbak%2C+NJ&rft.au=McGranahan%2C+N&rft.au=Lundquist%2C+M&rft.au=LaPlant%2C+Q&rft.au=Healey%2C+JH&rft.au=Elemento%2C+O&rft.au=Chung%2C+CH&rft.au=Lee%2C+NY&rft.au=Imielenski%2C+M&rft.au=Nanjangud%2C+G&rft.au=Pe%27er%2C+D&rft.au=Cleveland%2C+DW&rft.au=Powell%2C+SN&rft.au=Lammerding%2C+J&rft.au=Swanton%2C+C&rft.au=Cantley%2C+LC&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5785464&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Irwin_2013-38"><span class="mw-cite-backlink"><b><a href="#cite_ref-Irwin_2013_38-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFIrwinGreerKhatibTemel2013" class="citation journal cs1">Irwin KE, Greer JA, Khatib J, Temel JS, Pirl WF (February 2013). "Early palliative care and metastatic non-small cell lung cancer: potential mechanisms of prolonged survival". <i>Chronic Respiratory Disease</i>. <b>10</b> (1): <span class="nowrap">35–</span>47. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F1479972312471549">10.1177/1479972312471549</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23355404">23355404</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:6743524">6743524</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Chronic+Respiratory+Disease&rft.atitle=Early+palliative+care+and+metastatic+non-small+cell+lung+cancer%3A+potential+mechanisms+of+prolonged+survival&rft.volume=10&rft.issue=1&rft.pages=%3Cspan+class%3D%22nowrap%22%3E35-%3C%2Fspan%3E47&rft.date=2013-02&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A6743524%23id-name%3DS2CID&rft_id=info%3Apmid%2F23355404&rft_id=info%3Adoi%2F10.1177%2F1479972312471549&rft.aulast=Irwin&rft.aufirst=KE&rft.au=Greer%2C+JA&rft.au=Khatib%2C+J&rft.au=Temel%2C+JS&rft.au=Pirl%2C+WF&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-39"><span class="mw-cite-backlink"><b><a href="#cite_ref-39">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGarsaJangBaxiChen2021" class="citation journal cs1">Garsa A, Jang JK, Baxi S, Chen C, Akinniranye O, Hall O, et al. (2021). "Radiation Therapy for Brain Metastases: A Systematic Review". <i>Practical Radiation Oncology</i>. <b>11</b> (5): <span class="nowrap">354–</span>365. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.prro.2021.04.002">10.1016/j.prro.2021.04.002</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34119447">34119447</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Practical+Radiation+Oncology&rft.atitle=Radiation+Therapy+for+Brain+Metastases%3A+A+Systematic+Review&rft.volume=11&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E354-%3C%2Fspan%3E365&rft.date=2021&rft_id=info%3Adoi%2F10.1016%2Fj.prro.2021.04.002&rft_id=info%3Apmid%2F34119447&rft.aulast=Garsa&rft.aufirst=A&rft.au=Jang%2C+JK&rft.au=Baxi%2C+S&rft.au=Chen%2C+C&rft.au=Akinniranye%2C+O&rft.au=Hall%2C+O&rft.au=Larkin%2C+J&rft.au=Motala%2C+A&rft.au=Hempel%2C+S&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-40"><span class="mw-cite-backlink"><b><a href="#cite_ref-40">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFShahriyari2016" class="citation journal cs1">Shahriyari L (2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847566">"A new hypothesis: some metastases are the result of inflammatory processes by adapted cells, especially adapted immune cells at sites of inflammation"</a>. <i>F1000Research</i>. <b>5</b>: 175. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.12688%2Ff1000research.8055.1">10.12688/f1000research.8055.1</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847566">4847566</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27158448">27158448</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=F1000Research&rft.atitle=A+new+hypothesis%3A+some+metastases+are+the+result+of+inflammatory+processes+by+adapted+cells%2C+especially+adapted+immune+cells+at+sites+of+inflammation&rft.volume=5&rft.pages=175&rft.date=2016&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4847566%23id-name%3DPMC&rft_id=info%3Apmid%2F27158448&rft_id=info%3Adoi%2F10.12688%2Ff1000research.8055.1&rft.aulast=Shahriyari&rft.aufirst=L&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4847566&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-41"><span class="mw-cite-backlink"><b><a href="#cite_ref-41">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLópez-Lázaro2015" class="citation journal cs1">López-Lázaro M (2015-01-01). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468332">"The migration ability of stem cells can explain the existence of cancer of unknown primary site. Rethinking metastasis"</a>. <i>Oncoscience</i>. <b>2</b> (5): <span class="nowrap">467–</span>475. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.18632%2Foncoscience.159">10.18632/oncoscience.159</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468332">4468332</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26097879">26097879</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Oncoscience&rft.atitle=The+migration+ability+of+stem+cells+can+explain+the+existence+of+cancer+of+unknown+primary+site.+Rethinking+metastasis&rft.volume=2&rft.issue=5&rft.pages=%3Cspan+class%3D%22nowrap%22%3E467-%3C%2Fspan%3E475&rft.date=2015-01-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4468332%23id-name%3DPMC&rft_id=info%3Apmid%2F26097879&rft_id=info%3Adoi%2F10.18632%2Foncoscience.159&rft.aulast=L%C3%B3pez-L%C3%A1zaro&rft.aufirst=M&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC4468332&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Sarna_2019-42"><span class="mw-cite-backlink">^ <a href="#cite_ref-Sarna_2019_42-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Sarna_2019_42-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSarnaKrzykawska-SerdaJakubowskaZadlo2019" class="citation journal cs1">Sarna M, Krzykawska-Serda M, Jakubowska M, Zadlo A, Urbanska K (June 2019). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594928">"Melanin presence inhibits melanoma cell spread in mice in a unique mechanical fashion"</a>. <i>Scientific Reports</i>. <b>9</b> (1): 9280. <a href="/wiki/Bibcode_(identifier)" class="mw-redirect" title="Bibcode (identifier)">Bibcode</a>:<a rel="nofollow" class="external text" href="https://ui.adsabs.harvard.edu/abs/2019NatSR...9.9280S">2019NatSR...9.9280S</a>. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fs41598-019-45643-9">10.1038/s41598-019-45643-9</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594928">6594928</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31243305">31243305</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Scientific+Reports&rft.atitle=Melanin+presence+inhibits+melanoma+cell+spread+in+mice+in+a+unique+mechanical+fashion&rft.volume=9&rft.issue=1&rft.pages=9280&rft.date=2019-06&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6594928%23id-name%3DPMC&rft_id=info%3Apmid%2F31243305&rft_id=info%3Adoi%2F10.1038%2Fs41598-019-45643-9&rft_id=info%3Abibcode%2F2019NatSR...9.9280S&rft.aulast=Sarna&rft.aufirst=M&rft.au=Krzykawska-Serda%2C+M&rft.au=Jakubowska%2C+M&rft.au=Zadlo%2C+A&rft.au=Urbanska%2C+K&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6594928&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-43"><span class="mw-cite-backlink"><b><a href="#cite_ref-43">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFZarshenasMohammadi-Bardbori2017" class="citation journal cs1">Zarshenas MM, Mohammadi-Bardbori A (February 2017). "A medieval description of metastatic breast cancer; from Avicenna's view point". <i>Breast</i>. <b>31</b>: <span class="nowrap">20–</span>21. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.breast.2016.10.019">10.1016/j.breast.2016.10.019</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27810694">27810694</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Breast&rft.atitle=A+medieval+description+of+metastatic+breast+cancer%3B+from+Avicenna%27s+view+point&rft.volume=31&rft.pages=%3Cspan+class%3D%22nowrap%22%3E20-%3C%2Fspan%3E21&rft.date=2017-02&rft_id=info%3Adoi%2F10.1016%2Fj.breast.2016.10.019&rft_id=info%3Apmid%2F27810694&rft.aulast=Zarshenas&rft.aufirst=MM&rft.au=Mohammadi-Bardbori%2C+A&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-44"><span class="mw-cite-backlink"><b><a href="#cite_ref-44">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKardehKardeh2019" class="citation journal cs1">Kardeh S, Kardeh B (2019-01-01). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344088">"Avicenna's Concepts on Cancer Metastasis from the 11th Century"</a>. <i>Galen Medical Journal</i>. <b>8</b>: e1292. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.31661%2Fgmj.v8i0.1292">10.31661/gmj.v8i0.1292</a> (inactive 1 November 2024). <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8344088">8344088</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/34466487">34466487</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Galen+Medical+Journal&rft.atitle=Avicenna%27s+Concepts+on+Cancer+Metastasis+from+the+11th+Century&rft.volume=8&rft.pages=e1292&rft.date=2019-01-01&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8344088%23id-name%3DPMC&rft_id=info%3Apmid%2F34466487&rft_id=info%3Adoi%2F10.31661%2Fgmj.v8i0.1292&rft.aulast=Kardeh&rft.aufirst=S&rft.au=Kardeh%2C+B&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8344088&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span><span class="cs1-maint citation-comment"><code class="cs1-code">{{<a href="/wiki/Template:Cite_journal" title="Template:Cite journal">cite journal</a>}}</code>: CS1 maint: DOI inactive as of November 2024 (<a href="/wiki/Category:CS1_maint:_DOI_inactive_as_of_November_2024" title="Category:CS1 maint: DOI inactive as of November 2024">link</a>)</span></span> </li> <li id="cite_note-Kelland-cancer-45"><span class="mw-cite-backlink"><b><a href="#cite_ref-Kelland-cancer_45-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKelland2014" class="citation news cs1">Kelland K (17 March 2014). <a rel="nofollow" class="external text" href="https://www.reuters.com/article/us-cancer-ancient-idUSBREA2G1BL20140317">"Archaeologists discover earliest example of human with cancer"</a>. <i>Reuters</i><span class="reference-accessdate">. Retrieved <span class="nowrap">18 March</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Reuters&rft.atitle=Archaeologists+discover+earliest+example+of+human+with+cancer&rft.date=2014-03-17&rft.aulast=Kelland&rft.aufirst=K&rft_id=https%3A%2F%2Fwww.reuters.com%2Farticle%2Fus-cancer-ancient-idUSBREA2G1BL20140317&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Ghosh-cancer-46"><span class="mw-cite-backlink"><b><a href="#cite_ref-Ghosh-cancer_46-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGhosh2014" class="citation news cs1">Ghosh P (18 March 2014). <a rel="nofollow" class="external text" href="https://www.bbc.com/news/science-environment-26627941">"Ancient skeleton is the earliest case of cancer yet detected"</a>. <i>BBC</i><span class="reference-accessdate">. Retrieved <span class="nowrap">18 March</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=BBC&rft.atitle=Ancient+skeleton+is+the+earliest+case+of+cancer+yet+detected&rft.date=2014-03-18&rft.aulast=Ghosh&rft.aufirst=P&rft_id=https%3A%2F%2Fwww.bbc.com%2Fnews%2Fscience-environment-26627941&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> <li id="cite_note-Ross-cancer-47"><span class="mw-cite-backlink"><b><a href="#cite_ref-Ross-cancer_47-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFRoss2014" class="citation news cs1">Ross P (17 March 2014). <a rel="nofollow" class="external text" href="http://www.ibtimes.com/possible-oldest-cancer-found-3000-year-old-skeleton-could-reveal-evolution-modern-disease-1561953">"Possible Oldest Cancer Found In 3,000-Year-Old Skeleton Could Reveal 'Evolution' Of Modern Disease"</a>. <i>International Business Times</i><span class="reference-accessdate">. Retrieved <span class="nowrap">18 March</span> 2014</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=International+Business+Times&rft.atitle=Possible+Oldest+Cancer+Found+In+3%2C000-Year-Old+Skeleton+Could+Reveal+%27Evolution%27+Of+Modern+Disease&rft.date=2014-03-17&rft.aulast=Ross&rft.aufirst=P&rft_id=http%3A%2F%2Fwww.ibtimes.com%2Fpossible-oldest-cancer-found-3000-year-old-skeleton-could-reveal-evolution-modern-disease-1561953&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Metastasis&action=edit&section=18" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1235681985">.mw-parser-output .side-box{margin:4px 0;box-sizing:border-box;border:1px solid #aaa;font-size:88%;line-height:1.25em;background-color:var(--background-color-interactive-subtle,#f8f9fa);display:flow-root}.mw-parser-output .side-box-abovebelow,.mw-parser-output .side-box-text{padding:0.25em 0.9em}.mw-parser-output .side-box-image{padding:2px 0 2px 0.9em;text-align:center}.mw-parser-output .side-box-imageright{padding:2px 0.9em 2px 0;text-align:center}@media(min-width:500px){.mw-parser-output .side-box-flex{display:flex;align-items:center}.mw-parser-output .side-box-text{flex:1;min-width:0}}@media(min-width:720px){.mw-parser-output .side-box{width:238px}.mw-parser-output .side-box-right{clear:right;float:right;margin-left:1em}.mw-parser-output .side-box-left{margin-right:1em}}</style><style data-mw-deduplicate="TemplateStyles:r1237033735">@media print{body.ns-0 .mw-parser-output .sistersitebox{display:none!important}}@media screen{html.skin-theme-clientpref-night .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .sistersitebox img[src*="Wiktionary-logo-en-v2.svg"]{background-color:white}}</style><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Wiktionary-logo-en-v2.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/40px-Wiktionary-logo-en-v2.svg.png" decoding="async" width="40" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/60px-Wiktionary-logo-en-v2.svg.png 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/9/99/Wiktionary-logo-en-v2.svg/80px-Wiktionary-logo-en-v2.svg.png 2x" data-file-width="512" data-file-height="512" /></a></span></div> <div class="side-box-text plainlist">Look up <i><b><a href="https://en.wiktionary.org/wiki/Special:Search/metastasis" class="extiw" title="wiktionary:Special:Search/metastasis">metastasis</a></b></i> in Wiktionary, the free dictionary.</div></div> </div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1235681985"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1237033735"><div class="side-box side-box-right plainlinks sistersitebox"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1126788409"> <div class="side-box-flex"> <div class="side-box-image"><span class="noviewer" typeof="mw:File"><a href="/wiki/File:Commons-logo.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/30px-Commons-logo.svg.png" decoding="async" width="30" height="40" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/45px-Commons-logo.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/4/4a/Commons-logo.svg/59px-Commons-logo.svg.png 2x" data-file-width="1024" data-file-height="1376" /></a></span></div> <div class="side-box-text plainlist">Wikimedia Commons has media related to <span style="font-weight: bold; font-style: italic;"><a href="https://commons.wikimedia.org/wiki/Category:Metastases" class="extiw" title="commons:Category:Metastases">Metastases</a></span>.</div></div> </div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20120104211020/http://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic">"Q&A: Metastatic Cancer"</a>. <i><a href="/wiki/National_Cancer_Institute" title="National Cancer Institute">National Cancer Institute</a></i>. U.S. National Institutes of Health. Archived from <a rel="nofollow" class="external text" href="https://www.cancer.gov/cancertopics/factsheet/Sites-Types/metastatic">the original</a> on 4 January 2012.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=National+Cancer+Institute&rft.atitle=Q%26A%3A+Metastatic+Cancer&rft_id=http%3A%2F%2Fwww.cancer.gov%2Fcancertopics%2Ffactsheet%2FSites-Types%2Fmetastatic&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></li> <li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFSeahJun2014" class="citation web cs1">Seah I, Jun Y (20 November 2014). <a rel="nofollow" class="external text" href="https://www.youtube.com/watch?v=OcigJn8UJNQ&ab_channel=TED-Ed">"How does cancer spread – the route"</a>. <i>TED-Ed</i> – via YouTube.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=TED-Ed&rft.atitle=How+does+cancer+spread+%E2%80%93+the+route&rft.date=2014-11-20&rft.aulast=Seah&rft.aufirst=I&rft.au=Jun%2C+Y&rft_id=https%3A%2F%2Fwww.youtube.com%2Fwatch%3Fv%3DOcigJn8UJNQ%26ab_channel%3DTED-Ed&rfr_id=info%3Asid%2Fen.wikipedia.org%3AMetastasis" class="Z3988"></span></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 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("counter(listitem)"\a0 "}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q181876" class="extiw" title="d:Q181876">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D009362">D009362</a></li><li><b><a href="/wiki/Diseases_Database" title="Diseases Database">DiseasesDB</a></b>: <a rel="nofollow" class="external text" href="http://www.diseasesdatabase.com/ddb28954.htm">28954</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></b>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/002260.htm">002260</a></li></ul></div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Overview_of_tumors,_cancer_and_oncology148" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output 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template">e</abbr></a></li></ul></div><div id="Overview_of_tumors,_cancer_and_oncology148" style="font-size:114%;margin:0 4em">Overview of <a href="/wiki/Neoplasm" title="Neoplasm">tumors</a>, <a href="/wiki/Cancer" title="Cancer">cancer</a> and <a href="/wiki/Oncology" title="Oncology">oncology</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Conditions</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Benign_tumor" title="Benign tumor">Benign tumors</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hyperplasia" title="Hyperplasia">Hyperplasia</a></li> <li><a href="/wiki/Cyst" title="Cyst">Cyst</a></li> <li><a href="/wiki/Pseudocyst" title="Pseudocyst">Pseudocyst</a></li> <li><a href="/wiki/Hamartoma" title="Hamartoma">Hamartoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Malignant progression</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dysplasia" title="Dysplasia">Dysplasia</a></li> <li><a href="/wiki/Carcinoma_in_situ" title="Carcinoma in situ">Carcinoma in situ</a></li> <li><a href="/wiki/Cancer" title="Cancer">Cancer</a></li> <li><a class="mw-selflink selflink">Metastasis</a></li> <li><a href="/wiki/Primary_tumor" title="Primary tumor">Primary tumor</a></li> <li><a href="/wiki/Sentinel_lymph_node" title="Sentinel lymph node">Sentinel lymph node</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Topography</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Head_and_neck_cancer" title="Head and neck cancer">Head and neck</a> <ul><li><a href="/wiki/Oral_cancer" title="Oral cancer">oral</a></li> <li><a href="/wiki/Oropharyngeal_cancer" title="Oropharyngeal cancer">oropharyngeal</a></li> <li><a href="/wiki/Laryngeal_cancer" title="Laryngeal cancer">laryngeal</a></li> <li><a href="/wiki/Nasopharyngeal_carcinoma" title="Nasopharyngeal carcinoma">nasopharyngeal</a></li></ul></li> <li><a href="/wiki/Digestive_system_neoplasm" title="Digestive system neoplasm">Digestive system</a></li> <li><a href="/wiki/Neoplasm" title="Neoplasm">Respiratory system</a></li> <li><a href="/wiki/Bone_tumor" title="Bone tumor">Bone</a></li> <li><a href="/wiki/Skin_cancer" title="Skin cancer">Skin</a></li> <li><a href="/wiki/Leukemia" title="Leukemia">Blood</a></li> <li><a href="/wiki/Urogenital_neoplasm" title="Urogenital neoplasm">Urogenital</a></li> <li><a href="/wiki/Nervous_system_neoplasm" class="mw-redirect" title="Nervous system neoplasm">Nervous system</a></li> <li><a href="/wiki/Endocrine_gland_neoplasm" title="Endocrine gland neoplasm">Endocrine system</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Histology</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Carcinoma" title="Carcinoma">Carcinoma</a></li> <li><a href="/wiki/Sarcoma" title="Sarcoma">Sarcoma</a></li> <li><a href="/wiki/Blastoma" title="Blastoma">Blastoma</a></li> <li><a href="/wiki/Papilloma" title="Papilloma">Papilloma</a></li> <li><a href="/wiki/Adenoma" title="Adenoma">Adenoma</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Precancerous_condition" title="Precancerous condition">Precancerous condition</a></li> <li><a href="/wiki/Paraneoplastic_syndrome" title="Paraneoplastic syndrome">Paraneoplastic syndrome</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Cancer_staging" title="Cancer staging">Staging</a>/<a href="/wiki/Grading_(tumors)" title="Grading (tumors)">grading</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/TNM_staging_system" title="TNM staging system">TNM</a></li> <li><a href="/wiki/Ann_Arbor_staging" title="Ann Arbor staging">Ann Arbor</a></li> <li><a href="/wiki/Prostate_cancer_staging" title="Prostate cancer staging">Prostate cancer staging</a></li> <li><a href="/wiki/Gleason_grading_system" title="Gleason grading system">Gleason grading system</a></li> <li><a href="/wiki/Dukes_classification" class="mw-redirect" title="Dukes classification">Dukes classification</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Carcinogenesis" title="Carcinogenesis">Carcinogenesis</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cancer_cell" title="Cancer cell">Cancer cell</a></li> <li><a href="/wiki/Carcinogen" title="Carcinogen">Carcinogen</a></li> <li><a href="/wiki/Tumor_suppressor_gene" title="Tumor suppressor gene">Tumor suppressor genes</a>/<a href="/wiki/Oncogene" title="Oncogene">oncogenes</a></li> <li><a href="/wiki/Clonally_transmissible_cancer" title="Clonally transmissible cancer">Clonally transmissible cancer</a></li> <li><a href="/wiki/Oncovirus" title="Oncovirus">Oncovirus</a></li> <li><a href="/wiki/Carcinogenic_bacteria" title="Carcinogenic bacteria">Carcinogenic bacteria</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Misc.</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Cancer_research" title="Cancer research">Research</a></li> <li><a href="/wiki/Index_of_oncology_articles" title="Index of oncology articles">Index of oncology articles</a></li> <li><a href="/wiki/History_of_cancer" title="History of cancer">History</a></li> <li><a href="/wiki/Cancer_pain" title="Cancer pain">Cancer pain</a></li> <li><a href="/wiki/Cancer_and_nausea" title="Cancer and nausea">Cancer and nausea</a></li> <li><a href="/wiki/Diet_and_cancer" title="Diet and cancer">Diet</a></li> <li><a href="/wiki/Cancer_rehabilitation" title="Cancer rehabilitation">Rehabilitation</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style 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