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01-06-2012 | NON-THEMATIC REVIEW

Positive lymph nodes do not metastasize

Authors: Jutta Engel, Rebecca T. Emeny, Dieter Hölzel

Published in: Cancer and Metastasis Reviews | Issue 1-2/2012

Abstract

Our understanding of the role of lymph nodes (LN) in the metastasization process (MET) is marginal. Positive LNs (pLN) are the most important prognostic factor and lymph node dissection (LND) is still standard practice in primary treatment. However, up to now, there is almost no evidence that elective LND has a survival benefit. Based on many clinical and experimental findings, we propose that tumor foci in regional LN are incapable of metastasization and can therefore not infiltrate further LN and organs. Available data demonstrate a very early infiltration of MET capable tumor cells from the primary tumor into regional LN, and thereafter an increased probability of subsequent LN infiltrations. Disparate growth rates of the first versus subsequent infiltrating tumors as well as the asymptotic growth and prognosis of large tumor foci in LN explain many clinical observations for solid tumors. The consequence of the hypothesis “pLN do not metastasize” would impact clinical treatment and research and contribute to understanding the mounting evidence against LND.

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Title: Positive lymph nodes do not metastasize
Authors: Jutta Engel
Rebecca T. Emeny
Dieter Hölzel
Publication date: 01-06-2012
Publisher: Springer US
Published in: Cancer and Metastasis Reviews / Issue 1-2/2012
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI: https://doi.org/10.1007/s10555-011-9343-7

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