Fig. 1

The carcinogenesis and the metastatic cascade. The carcinogenesis and the metastatic cascade are complex processes that comprise the mechanisms associated with the primary tumor and its colonization of other organs (metastasis). The first phase is the primary tumor growth (1) followed by the generation of new capillary blood vessels (2), a crucial step for tumor progression and invasion. Once the cancer cells undergo the epithelial-to-mesenchymal transition (EMT), they acquire the metastatic phenotype (3), which allows the cells to move and enter the blood vessels through intravasation (4) and leave them (extravasation, 5) when they reach distant organs, the metastatic sites (6)