Occult metastasis

The most important factor affecting the outcome of patients with invasive c ancers is whether the tumor has spread, either regionally (to regional lymp h nodes) or systemically. However, a proportion of patients with no evidenc e of systemic dissemination will develop recurrent disease after primary 'c urative' therapy. Clearly, these patients had occult systemic spread of dis ease that was undetectable by methods routinely employed (careful pathologi cal, clinical, biochemical and radiological evaluation). In addition, the s uccess of adjuvant therapy is assumed to stem from its ability to eradicate occult metastases before they become clinically evident [1]. Therefore, me thods for the detection of occult metastases in patients with the earliest stage of cancer, i.e., prior to detection of metastases by any other clinic al or pathological analysis, have received a great deal of attention. (C) 2 001 Editions scientifiques et medicates Elsevier SAS.