Abstract
BackgroundMetastasis is the main cause of mortality in cancer patients. Two major routes of cancer cell spread are currently being recognized: dissemination via blood vessels (hematogenous spread) and dissemination via the lymphatic system (lymphogenous spread). Here, our current knowledge on the role of both blood and lymphatic vessels in cancer cell metastasis is summarized. In addition, I will discuss why cancer cells select one or both of the two routes to disseminate and I will provide a short description of the passive and active models of intravasation. Finally, lymphatic vessel density (LVD), blood vessel density (BVD), interstitial fluid pressure (IFP) and tumor hypoxia, as well as regional lymph node metastasis and the recently discovered primo vascular system (PVS) will be highlighted as important factors influencing tumor cell motility and spread and, ultimately, clinical outcome.ConclusionsLymphangiogenesis and angiogenesis are important phenomena involved in the spread of cancer cells and they are associated with a poor prognosis. It is anticipated that new discoveries and advancing knowledge on these phenomena will allow an improvement in the treatment of cancer patients.
Highlights
ConclusionsLymphangiogenesis and angiogenesis are important phenomena involved in the spread of cancer cells and they are associated with a poor prognosis
It has firmly been established that high mortality rates in cancer patients are associated with the occurrence of primary tumors but, even more profoundly, with the occurrence of metastases [1,2,3]
The tumor stroma is composed of non-cellular components of the extracellular matrix (ECM) such as proteins, glycoproteins, proteoglycans and polysaccharides endowing complex physical and biological properties to the stroma, as well as immune cells, endothelial cells and fibroblasts (CAFs) that participate in the early stages of tumor cell dissemination [47, 48]
Summary
Lymphangiogenesis and angiogenesis are important phenomena involved in the spread of cancer cells and they are associated with a poor prognosis. It is anticipated that new discoveries and advancing knowledge on these phenomena will allow an improvement in the treatment of cancer patients
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