Local tumor control and survival: clinical evidence and tumor biologic basis

Clinical and tumor biologic evidence indicates that local tumor recurrence is associated with a higher rate of distant metastases and adverse effects on patient survival. The findings discussed in this article are based on results from breast, prostate, and lung carcinoma, all tumors with high metastatic potential for which local tumor control was thought to be relatively unimportant. The fact that local tumor recurrence is associated with tumor progression and significant increases in distant metastases has important consequences in the relative emphasis on and the sequencing of locoregional and systemic therapies in the future.