Chance mechanisms affecting the burden of metastasesReport as inadecuate

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BMC Cancer

, 5:138

First Online: 26 October 2005Received: 10 July 2005Accepted: 26 October 2005DOI: 10.1186-1471-2407-5-138

Cite this article as: Kendal, W.S. BMC Cancer 2005 5: 138. doi:10.1186-1471-2407-5-138


BackgroundThe burden of cancer metastases within an individual is commonly used to clinically characterize a tumor-s biological behavior. Assessments like these implicitly assume that spurious effects can be discounted. Here the influence of chance on the burden of metastasis is studied to determine whether or not this assumption is valid.

MethodsMonte Carlo simulations were performed to estimate tumor burdens sustained by individuals with cancer, based upon empirically derived and validated models for the number and size distributions of metastases. Factors related to the intrinsic metastatic potential of tumors and their host microenvironments were kept constant, to more clearly demonstrate the contribution from chance.

ResultsUnder otherwise identical conditions, both the simulated numbers and the sizes of metastases were highly variable. Comparable individuals could sustain anywhere from no metastases to scores of metastases, and the sizes of the metastases ranged from microscopic to macroscopic. Despite the marked variability in the number and sizes of the metastases, their respective growth times were rather more narrowly distributed. In such situations multiple occult metastases could develop into fully overt lesions within a comparatively short time period.

ConclusionChance can have a major effect on the burden of metastases. Random variability can be so great as to make individual assessments of tumor biology unreliable, yet constrained enough to lead to the apparently simultaneous appearance of multiple overt metastases.

List of abbreviationsPNBPoisson negative binomial

PGFprobability generating function

CDFcumulative distribution function

SDstandard deviation.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-5-138 contains supplementary material, which is available to authorized users.

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Author: Wayne S Kendal


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