Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery

Core Tip

Core tip: This invited editorial looks for the role of intra-peritoneal free cancer cells (IFCC) in the surgical practice for colorectal cancer. Prognostic significance of IFCC in colorectal cancer patients is still not clear. Several studies have been published but detection systems are still highly heterogeneous and results remain misleading. Peritoneal cytology could be useful in early-stage cancers to identify subsets of patients with potential worse prognosis, who may be good candidates for adjuvant treatment or even prophylactic intraperitoneal chemotherapy. Current available data need stronger validation to include IFCC in the routine staging protocols of colorectal cancer patients. However, it is the authors’ belief that cancer cells found free in the peritoneum of patients with colon cancer, must have a biological and a clinical role. The means of detection based on real time polymerase chain reaction, will surely add power to conventional cytology and with the improvement in sensibility of the methods the clinical role of IFCC could eventually become clear. New therapy protocols might be applied.