9th Annual Symposium
Physics of Cancer
Leipzig, Germany
September 24-26, 2018
Invited Talk
Cancer resection within morphogenetic fields
Benjamin Wolf
Leipzig University Medical Center, Department of Obstetrics and Gynecology
Wide tumour excision – i.e. the resection of a malignant neoplasm with a metrically defined circumferential margin of healthy tissue – is currently the standard approach to the surgical treatment of solid cancers including carcinomas of the lower genital tract. This strategy is based on the premise that tumours grow isotropically. We reviewed the local spreading patterns of 518 carcinomas of the uterine cervix. We found that some anatomical structures such as the urinary bladder and its support structures were significantly more likely to be infiltrated by cervical cancer than other structures such as the ureter or the rectum with its support structures. Computational tumour spread models assuming isotropic growth could not explain these infiltration patterns. Introducing ontogenetic tissue properties as an additional parameter led to accurate prediction of the clinically observed tissue specific infiltration likelihoods. The prevailing assumption of isotropic tumour extension has significant shortcomings in the case of cervical cancer. Rather, cervical cancer spread seems to follow ontogenetically defined trajectories and cancer resection strategies should be adapted to these findings. Orthotopic tumour transplantation experiments can be used to investigate the mechanistic causes of these ontogenetically determined growth patterns.
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