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World J Gastroenterol. Feb 28, 2014; 20(8): 1935-1939
Published online Feb 28, 2014. doi: 10.3748/wjg.v20.i8.1935
Intra-operative peritoneal lavage for colorectal cancer
Guillaume Passot, Kayvan Mohkam, Eddy Cotte, Olivier Glehen
Guillaume Passot, Kayvan Mohkam, Eddy Cotte, Olivier Glehen, Departement of General and Surgical Oncology, Hospices Civils de Lyon, 69495 Pierre Bénite, France
Guillaume Passot, Kayvan Mohkam, Eddy Cotte, Olivier Glehen, EMR 3738, Université Lyon 1, F-69364 Lyon, France
Author contributions: All authors contributed to the design and editing for the manuscript; Mohkam K and Passot G wrote the article.
Correspondence to: Olivier Glehen, MD, PhD, Departement of General and Surgical Oncology, Hospices Civils de Lyon, CH Lyon Sud, 69495 Pierre Bénite, France. olivier.glehen@chu-lyon.fr
Telephone: +33-7-8865742 Fax: +33-7-8863343
Received: September 27, 2013
Revised: November 28, 2013
Accepted: January 6, 2014
Published online: February 28, 2014
Abstract

Free cancer cells can be detected in peritoneal fluid at the time of colorectal surgery. Peritoneal lavage in colorectal surgery for cancer is not used in routine, and the prognostic significance of intraperitoneal free cancer cells (IPCC) remains unclear. Data concerning the technique of peritoneal lavage to detect IPCC and its timing regarding colorectal resection are scarce. However, positive IPCC might be the first step of peritoneal spread in colorectal cancers, which could lead to early specific treatments. Because of the important heterogeneity of IPCC determination in reported studies, no treatment have been proposed to patients with positive IPCC. Herein, we provide an overview of IPCC detection and its impact on recurrence and survival, and we suggest further multi-institutional studies to evaluate new treatment strategies.

Keywords: Peritoneal carcinomatosis, Colorectal cancer, Free intraperitoneal cells, Immunocytochemistry

Core tip: We provide an overview of intraperitoneal free cancer cells (IPCC) detection and its impact on recurrence and survival, and we suggest further multi-institutional studies to evaluate new treatment strategies. Moreover, while current literature is sufficient to consider positive IPCC as a pejorative prognostic factor, further studies are also needed to propose adjuvant treatment for patients with positive IPCC.