Oesophageal cancer is a particularly insidious disease, and its incidence is rising in the developed world. It has usually begun to metastasize by the time it is diagnosed, and cure rates are low. If the metastatic escape routes of cancer cells could be predicted, we might be able to block their migration. The many lymphatic vessels that drain a tumour are the logical pathways for cancer cells to follow, but which ones will tumour cells use to spread to distant sites? A team led by Michael Griffin at the University of Newcastle, UK, has developed a simple method that tracks the most likely metastatic highways for oesophageal cancer. By injecting a blue dye and a radiolabelled colloid into the tumour margins, they can follow lymphatic drainage during surgery and remove those lymph nodes to which the radioactivity — and hence the tumour cells — are draining. In the 40 patients monitored so far, immunohistochemistry has confirmed that the technique is 95% accurate.
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