Cancer Stem Cell and Clinical Cancer Metastasis in Surgical Oncology
Pp. 109-133 (25)
Shoji Nakamori and Koji Morimoto
The cancer stem cell (CSC) theory has emerged as an attractive hypothesis
for tumor development and progression including metastasis. The theory suggests that
tumors consist of subsets of cells with functional heterogeneity in which one small
subset has the characteristics of stem cells. These stem cells have the capacity of both
self-renewal and heterogeneous differentiation into cancer cells that comprise the
tumor. They can also play an important role in invasion, metastasis and, finally,
recurrence. Based on the pathgenesis of the cancer metastasis, the recurrences after
curative surgery probably develop from the proliferation of occult micro-metastases
already established at the time of surgery. The attractive ideas about CSCs hypothesis
in metastasis can partially explain the concept of minimal residual disease like occult
micro-metastases after curative resections. CSC hypothesis in clinical metastasis is now
giving a deep impact on surgical oncology. Efforts to develop diagnostic and
therapeutic approach with the successful results from CSC studies would lead to
impressive improvement for cancer patients in surgery.
Adjuvant chemotherapy, Biomarker, Cancer, Cancer stem cell (CSC),
Circulating tumor cells (CTC), Disseminating tumor cells (DTC), Epithelialmesencymal
transition (EMT), Mesenchymal-epithelial transition (MET),
Metastasis, Micro-metastases, Prognosis, Recurrence, R0 resection, Surgery,
Surgical oncology, Target therapy.
Department of Hepatobiliary-Pancreatic Surgery, Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan.