title: Detection methods and clinical significance of free peritoneal tumor cells found during colorectal cancer surgery.
abstract: Peritoneal washing is now part of the standard clinical practice in several abdominal and pelvic neoplasias. However, in colorectal cancer surgery, intra-peritoneal free cancer cells (IFCC) presence is not routinely investigated and their prognostic meaning is still unclear. When peritoneal washing results are positive for the presence of IFCC a worse outcome is usually expected in these colorectal cancer operated patients, but it what is not clear is whether it is associated with an increased risk of local recurrence. It is authors' belief that one of the main reasons why IFCC are not researched as integral part of the routine staging system for colon cancer is that there still isn't a diagnostic or detection method with enough sensibility and specificity. However, the potential clinical implications of a routine research for the presence IFCC in colon neoplasias are enormous: not only to obtain a more accurate clinical staging but also to offer different therapy protocols, based on the presence of IFCC. Based on this, adjuvant chemotherapy could be offered to those patients found to be positive for IFCC; also, protocols of proactive intraperitoneal chemotherapy could be applied. Although presence of IFCC appears to have a valid prognostic significance, further studies are needed to standardize detection and examination procedures, to determine if there are and which are the stages more likely to benefit from routine search for IFCC.
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Sibio
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Fiorani
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Stolfi
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Divizia
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pezzuto
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montagnese
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Bagaglini
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Sammartino
authors.affiliation: Simone Sibio, Paolo Sammartino, Department of Surgery Pietro Valdoni, Sapienza University of Rome, 00155 Rome, Italy.
authors.forename: Giuseppe Sigismondo
authors.initials: GS
authors.lastname: Sica
keywords: Colorectal cancer; Cytology; Free cancer cells; Peritoneal recurrence; Proactive treatment