Tumour micrometastases: the influence of angiogenesis

Introduction: Many cancer patients have undetected micrometastatic disease at first presentation which ultimately progresses. Angiogenesis-the develop ment of an independent blood supply-is a key event in the growth of metasta ses. Improved understanding of the influence of angiogenesis on micrometast atic growth may lead to new therapeutic intervention. Methods: This study examines current concepts of the significance of microm etastases and the role of angiogenesis in their development and destruction . A comprehensive review of the literature on micrometastasis and angiogene sis was performed using the Medline database between 1966 and 1999. Conclusions: Advances in technology have improved our ability to diagnose m etastatic disease, but micrometastases in loco-regional lymph nodes and at distant sites can only be detected by sophisticated histological techniques . While the significance of micrometastases remains controversial, there is increasing evidence that micrometastatic status provides useful prognostic information and should be part of standard staging techniques. Anti-angiog enic therapy has the potential to favourably influence management of certai n cancers by manipulating a number of key events in the metastatic process.