In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology. Surgical resection for peritoneal metastases from colorectal cancer (CRC) has been gradually accepted in the medical oncology community. A randomized trial (PRODIGE 7) on cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin. Nevertheless, isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver. Another tool is required in those patients to achieve more local control of the disease. Surgical groups in peritoneal surgery continue to use HIPEC in their procedures, using other agents than oxaliplatin for peritoneal cavity infusion, such as mitomycin C. These patients present with complex surgical issues to manage, and consequently a large burden of complications has to be anticipated. Therefore, identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

Colorectal cancer (CRC) is a type of cancer that grows from polypoid lesions developing over the years. It has a high incidence of about 1.8 million new cases annually. While screening and lifestyle modifications have stabilized the rate of CRC in high-income countries, the incidence of early-onset CRC is increasing globally. The worst prognosis for this cancer is linked to recurrence and metastasis, with peritoneal metastasis occurring in 8% to 20% of cases. In these cases, treatment with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy is indicated. However, this approach is risky and requires careful selection of patients who will truly benefit from it. This article will discuss the correlation between nutrition and inflammation in patients with peritoneal metastasis and advanced CRC, emphasizing the importance of nutritional and inflammatory markers for assessing disease status. Finally, we will highlight the main biomarkers in the field.