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The Tumor Microenvironment02:17

The Tumor Microenvironment

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Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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Tumor seeding across specialties: a systematic review.

Pavel Kipnis1, Diya Ramanathan2, Richard Hoehn1,3

  • 1Case Western Reserve University School of Medicine, Cleveland, OH, United States.

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|November 28, 2024
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Summary

Tumor seeding is a significant risk during cancer procedures, frequently linked to laparoscopy and needle biopsies. Current cancer guidelines (NCCN/NICE) need updates to address this risk and improve patient outcomes.

Keywords:
canceriatrogenicinstrumentationseedingtumor seeding

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Cancer Research

Background:

  • Tumor seeding, the spread of cancer cells during medical procedures, poses a significant clinical challenge.
  • Understanding the factors contributing to tumor seeding is crucial for refining surgical techniques and patient management.

Purpose of the Study:

  • To systematically review tumor seeding episodes across various medical specialties.
  • To identify specific instrumentation and primary tumor histologies associated with increased tumor seeding risk.

Main Methods:

  • A systematic review of literature from 1965 to 2022 was performed using PubMed and Web of Science, adhering to PRISMA guidelines.
  • Studies reporting five or more seeding cases were included, with data analyzed by specialty, instrumentation, and tumor type.

Main Results:

  • Analysis of 156 papers revealed 8,161 tumor seeding cases, predominantly in general surgery, gastroenterology, and urology.
  • Laparoscopy (1,561 cases) and needle biopsy (3,448 cases) were the most implicated procedures.
  • Carcinomas (5,778 cases) and adenocarcinomas (1,090 cases) were the most common primary tumor types associated with seeding.

Conclusions:

  • Significant gaps exist in current National Comprehensive Cancer Network (NCCN) and National Institute for Health and Care Excellence (NICE) guidelines regarding tumor seeding.
  • Recommendations for modifying cancer care guidelines are proposed to incorporate seeding risk management.