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Prisoner's Dilemma Article in Annals of surgery · July 2012 DOI: 10.1097/SLA.0b013e31825b6f38 · Source: PubMed
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LETTER TO THE EDITOR Prisoner’s Dilemma To the Editor: l-Sahaf et al1 report that the removal of the primary tumor led to a progressive phenotype of lung metastases that exhibited upregulation of genes involved in adhesion, invasion, and angiogenesis. I hope to give a simplified explanation of the process on the basis of game theory. A few clinical investigations suggest that while surgical removal of primary breast cancer favorably modifies the natural history for some patients, it may also hasten metastatic development for others. The concepts underlying this disease paradigm, that is, tumor homeostasis, tumor dormancy, and surgery-driven enhancement of metastasis development, have a long history.2 The evolution of cooperation has a well-established theoretical framework based on game theory. At a fundamental level, the field of game theory evolved from the mathematical exploration of conflict situations between rational entities that make predictable and reproducible choices. Subsequent mathematical formulae are derived from and are dependent on these prerequisites.3
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Game theory has made valuable contributions to a wide variety of disciplines, including political science, economics, and biology. The prototypical example is the Prisoner’s Dilemma, where the payoff from a specific strategy depends on whether the other player collaborates or defects.4 We can apply this theory to cancer by regarding primary tumor and metastases as players. The evolutionary interpretation of game theory uses standard Darwinian principles: players interact with each other and their environment, phenotypes are heritable, change occurs in heritable genotypes by mutation and other mechanisms, individuals compete for limited resources, and there is selection. Two kinds of cooperation have been recognized: commensalism, in which one player of a pair benefits but the other doesn’t and mutualism, in which both benefit, resulting in synergy. In each case, new properties may emerge in a cooperating group that the players do not exhibit individually. Cooperation among players may take the form of byproduct mutualism by sharing resources. At least 3 of the hallmarks involve sharable resources: angiogenesis, self-sufficiency of certain growth signals, and tissue invasion and metastasis.4
In conclusion, we metastasis pathophysiology text of game theory and missing frames within the able to correctly describe interactions.
can reevaluate within the contry to get the sequence to be their nonlinear
Mesut Tez Ankara Numune Teaching and Research Hospital Fifth Surgical Clinic Ankara, Turkey
[email protected] [email protected]
REFERENCES 1. Al-Sahaf O, Wang JH, Browne TJ, et al. Surgical injury enhances the expression of genes that mediate breast cancer metastasis to the lung. Ann Surg. 2010;252:1037–1043. 2. Demicheli R, Retsky MW, Hrushesky WJ, et al. The effects of surgery on tumor growth: a century of investigations. Ann Oncol. 2008;19:1821–1828. 3. McEvoy JW. Evolutionary game theory: lessons and limitations, a cancer perspective. Br J Cancer. 2009;101:2060–2061. 4. Axelrod R, Axelrod DE, Pienta KJ. Evolution of cooperation among tumor cells. Proc Natl Acad Sci USA. 2006;103:13474–13479.
Disclosure: The author declares no conflicts of interest. C 2012 by Lippincott Williams & Wilkins Copyright ISSN: 0003-4932/12/25601-e0004 DOI: 10.1097/SLA.0b013e31825b6f38
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Annals of Surgery r Volume 256, Number 1, July 2012
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