Interactions of cancer cells with the microvasculature during metastasis 1 2

Metastasis of cancer via the bloodstream is a major factor in the diagnosis, treatment, and prognosis of patients with cancer. Key events in hematogenous metastasis occur in the microvasculature. This is a brief, selective review of some interactions involving cancer cells and the microvasculature in pathological sequence, specifically: 1 ) intravasation of cancer cells; 2 ) the arrest of circulating cancer in the microvasculature; 3 ) cancer cell trauma associated with arrest; 4 ) microvascular trauma; 5) the inflammatory and 6 ) coagulative responses associated with arrest; and 7 ) the fate of arrested cancer cells. The evidence shows that in addition to providing routes for cancer cell dissemination and arrest sites for cancer cell emboli, the microvasculature, through a series of complex interactions with cancer cells, controls the efficiency of and acts as a rate regulator for the metastatic process.—W eiss , L.; O rr , F. W.; H onn , K. V. Interactions of cancer cells with the microvasculature during metastasis. FASEB J. 2: 12‐21; 1988.