Peritoneal minimal residual disease in colorectal cancer: mechanisms, prevention, and treatment

Area of Science:

• Oncology
• Gastroenterology
• Surgical Oncology

Background:

• Colorectal cancer (CRC) frequently metastasizes to the peritoneum, a condition known as peritoneal carcinomatosis.
• Peritoneal metastasis affects approximately 15% of CRC patients post-surgery.
• Unlike hematogenous metastasis, the biology of peritoneal spread in CRC is poorly understood.

Purpose of the Study:

• To review the molecular mechanisms underlying colorectal cancer peritoneal metastasis.
• To identify potential preventive strategies for peritoneal carcinomatosis.
• To elucidate the steps involved in the peritoneal metastatic cascade.

Main Methods:

• Literature review of studies on colorectal cancer peritoneal metastasis.
• Analysis of molecular pathways involved in peritoneal spread.
• Synthesis of current knowledge on preventive measures.

Main Results:

• Peritoneal carcinomatosis develops through sequential steps: cell shedding, adhesion, invasion, and proliferation.
• Specific molecular mechanisms drive each stage of the peritoneal metastatic cascade.
• Understanding these mechanisms offers targets for prevention.

Conclusions:

• Targeting molecular mechanisms at each step of the peritoneal metastatic cascade may prevent carcinomatosis.
• Further research into peritoneal spread biology is crucial for developing effective therapies.
• Preventive strategies could significantly improve outcomes for CRC patients at risk of peritoneal metastasis.