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Demonstration of the Presence of Circulating Tumor Cells as Evidence of Metastatic Potential
Savio G. Barreto, MS;
Parul J. Shukla, MS, FRCS
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We read with interest the article by Steinert et al1 in which they presented their prospective data on the influence of subclinical tumor spreading markers on survival after curative surgery for colorectal cancer. We appreciate their work and the idea of incorporating the detection of tumor cells in lymph nodes, peritoneal lavage fluid, and bone marrow as markers of local, locoregional, and distant spread.
What we found surprising is the labeling of the presence of abnormal cells (positive for epithelial markers that are not tumor-specific) at ectopic sites from the primary tumor as minimal residual disease. The concept of circulating tumor cells is not new and has been one of the most researched topics in solid organ cancers, including colorectal cancer, ever since its first description.2 We feel that it is not the demonstration of the presence but the "proliferative potential"3 . . . [Full Text of this Article]
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