Surgery and stem cell niches: An Achilles' heel of metastatic cancer

According to a classic paradigm, surgery only plays a palliative role in patients with metastatic cancer in whom the possibility of a radical resection is non-viable. However, some convincing data proceeding from two randomized trials carried out in patients with metastatic kidney cancer have challenged this assumption. The hypothesis proposes that the resection of the primary tumour in metastatic cancer is the first generation of forthcoming therapies aiming at stem cell niches. It will independently improve the prognosis of metastatic cancer in patients that are fit enough to tolerate major surgery. The phenomenon of late relapses could also be explained on this basis.