Parallel progression of primary tumours and metastases

Nat Rev Cancer. 2009 Apr;9(4):302-12. doi: 10.1038/nrc2627.


Systemic cancer progression is accounted for in two basic models. The prevailing archetype places the engine of cancer progression within the primary tumour before metastatic dissemination of fully malignant cells. The second posits parallel, independent progression of metastases arising from early disseminated tumour cells. This Perspective draws together data from disease courses, tumour growth rates, autopsy studies, clinical trials and molecular genetic analyses of primary and disseminated tumour cells in support of the parallel progression model. Consideration of this model urges review of current diagnostic and therapeutic routines.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Disease Progression
  • Humans
  • Models, Theoretical
  • Neoplasm Metastasis / genetics
  • Neoplasm Metastasis / pathology*
  • Neoplasms / genetics
  • Neoplasms / pathology*