A substantial fraction (30-50%) of patients who undergo surgery for localized cancer with regional lymph node removal will manifest metastatic disease within a few years, indicating they had microscopic metastatic disease from before the surgery.

“a substantial fraction of those patients let's go with 30 50% you know kind of typical range — over those few to several years of followup will manifest metastic disease well they always had it they had it they had it from before the surgery was ever done — and as you said basically they actually cancer cells this or the analogy of the traveler left the airport I mean they actually they you know they did they lodged in a you know distant sight — we just didn't have the methods you know to find it”