Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Unifying metastasis — integrating intravasation, circulation and end-organ colonization


Recent technological advances that have enabled the measurement of circulating tumour cells (CTCs) in patients have spurred interest in the circulatory phase of metastasis. Techniques that do not solely rely on a blood sample allow substantial biological interrogation beyond simply counting CTCs.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1: A simplified representation of the human vascular system connecting representative organs with a primary tumour in the liver.


  1. Marrinucci, D. et al. Case study of the morphologic variation of circulating tumor cells. Hum. Pathol. 38, 514–519 (2007).

    Article  PubMed  Google Scholar 

  2. Jiao, L. R. et al. Unique localization of circulating tumor cells in patients with hepatic metastases. J. Clin. Oncol. 27, 6160–6165 (2009).

    Article  PubMed  Google Scholar 

  3. Paget, S. The distribution of secondary growths in cancer of the breast. 1889. Cancer Metastasis Rev. 8, 98–101 (1989).

    CAS  PubMed  Google Scholar 

  4. Valastyan, S. & Weinberg, R. Tumor metastasis: molecular insights and evolving paradigms. Cell 147, 275–292 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Gerlinger, M. et al. Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N. Engl. J. Med. 366, 883–892 (2012).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Meng, S. et al. Circulating tumor cells in patients with breast cancer dormancy. Clin. Cancer Res. 10, 8152–8162 (2004).

    PubMed  Google Scholar 

  7. Stott, S. L. et al. Isolation and characterization of circulating tumor cells from patients with localized and metastatic prostate cancer. Science Transl Med. 2, 25ra23 (2010).

    Article  Google Scholar 

Download references


The authors would like to thank K. Kadyshevskaya for her help with the figure. This work was supported by PS-06 grant numbers US4CA143970 and US4CA143906 from the National Cancer Institute (NCI), USA. The content is solely the responsibility of the authors and does not necessarily represent the views of the NCI.

Author information

Authors and Affiliations


Corresponding authors

Correspondence to Jacob Scott or Alexander R. A. Anderson.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Related links

Related links


Alexander R. A. Anderson's homepage

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scott, J., Kuhn, P. & Anderson, A. Unifying metastasis — integrating intravasation, circulation and end-organ colonization. Nat Rev Cancer 12, 445–446 (2012).

Download citation

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing: Cancer

Sign up for the Nature Briefing: Cancer newsletter — what matters in cancer research, free to your inbox weekly.

Get what matters in cancer research, free to your inbox weekly. Sign up for Nature Briefing: Cancer