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Annals of Oncology Advance Access published online on June 10, 2008
Annals of Oncology, doi:10.1093/annonc/mdn386
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

review

The effects of surgery on tumor growth: a century of investigations

R. Demicheli1,*, M. W. Retsky2, W. J. M. Hrushesky3, M. Baum4 and I. D. Gukas5

1 Department of Medical Oncology, Istituto Nazionale Tumori, Milano, Italy
2 Department of Vascular Biology, Children’s Hospital and Harvard Medical School, Boston, USA
3 Department of Cell and Developmental Biology and Anatomy, School of Medicine, Dorn Veterans Affairs Medical Center, University of South Carolina, Columbia, USA
4 University College London, Consulting Rooms, Portland Hospital, London
5 School of Medicine, Health Policy and Practice, University of East Anglia, Norwich UK

* Correspondence to: Dr R. Demicheli, Department of Medical Oncology, Istituto Nazionale Tumori, Milano, Italy. Tel: +39-02-2390-3027; Fax: +39-02-2665642; E-mail: demicheli{at}istitutotumori.mi.it

A few clinical investigations suggest that while primary breast cancer surgical removal favorably modifies the natural history for some patients, it may also hasten the metastatic development for others. The concepts underlying this disease paradigm, i.e. tumor homeostasis, tumor dormancy and surgery-driven enhancement of metastasis development, have a long history that is reviewed. The review reveals the context in which these concepts were conceived and structured to explain experimental data and shows that they are not so new and far fetched. The idea that surgical cancer resection has both beneficial and adverse effects upon cancer spread and growth that result from the modulation of tumor dormancy by the resection should be considered a potentially fruitful working hypothesis.

breast cancer, metastasis development, surgery effects, tumor dormancy, tumor homeostasis

Received for publication March 28, 2008. Accepted for publication May 14, 2008.


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