In early-stage non-small-cell lung cancer (NSCLC), a substantial proportion of 
patients can be cured by surgery. Development of distant metastases is the most 
frequent cause of therapeutic failure. The possibility to accurately predict a 
patient's risk for developing distant metastasis would help to identify patients 
that are candidates for further intervention such as conventional adjuvant 
chemotherapy or experimental drugs. Current molecular biology techniques allow 
the genome-wide screening for differentially expressed genes; and adequate 
bioinformatics approaches are developed at a rapid pace to improve prognosis 
prediction. Genes associated with metastasis do not necessarily play a role in 
disease pathogenesis but rather reflect the activation of specific 
signal-transduction pathways that are associated with enhanced migration and 
invasion capability. In our own work, we have identified several genes (e.g. 
thymosin beta-4, elF4A1), including a novel non-coding RNA (MALAT-1) to be 
expressed at significantly higher levels in stage-I and stage-II NSCLC primary 
tumours that subsequently metastasised. As a consequence, patients with 
high-level expression of these genes were shown to have significantly worse 
survival compared to patients with low-level expression of these genes. These 
data support the hypothesis that gene-expression patterns in primary tumours 
determine the tumours' likelihood to metastasise. In the near future, this 
information will be used for tailored therapy approaches for patients with 
early-stage NSCLC.