Advancing Personalized Treatment: Prognostic Tools in Colorectal and Hepatic Cancer

In colorectal and hepatocellular cancers, clinicians are testing prognostic tools to flag patients at highest risk while grappling with how to act on those signals without overtreating, even as validation and standardization lag.

Against that tension, peritoneal lavage cytology in colorectal cancer and immune-related long non-coding RNA signatures in hepatocellular carcinoma are emerging as contrasting examples—one already informing risk discussions, the other still largely investigational.

Peritoneal lavage cytology detects free malignant cells in the peritoneal cavity and, when positive, is associated with a higher risk of peritoneal recurrence in Stage II–III colorectal cancer, informing risk discussions and follow-up planning; findings summarized in this Springer article align with that association.

In selected centers or within clinical trials, a positive peritoneal cytology result may prompt closer surveillance or consideration of intraperitoneal strategies; more broadly, it functions as a risk stratifier rather than a stand‑alone trigger for aggressive therapy.

Emerging immune-related long non-coding RNA signatures show prognostic potential and exploratory associations with therapy response in hepatocellular carcinoma, based largely on retrospective cohorts; they are not yet integrated into routine decision-making.

At the operative and perioperative level in colorectal cancer, cytology‑informed risk can shape discussions about staging procedures and surveillance intensity. Looking ahead, molecular signatures such as immune‑related lncRNAs are being evaluated for risk stratification in hepatocellular carcinoma, but they remain investigational.

Patients who receive clearer risk information may perceive greater alignment of care with their goals; this is distinct from proven improvements in survival or quality‑of‑life outcomes.

Key Takeaways:

• Promise versus practice: new prognostic signals are arriving faster than validation and implementation frameworks, forcing careful calibration to avoid overtreatment.
• In colorectal cancer, peritoneal lavage cytology can support risk stratification and inform surveillance or procedural planning, with adoption varying by center.
• In hepatocellular carcinoma, immune‑related lncRNA signatures are investigational—early studies suggest prognostic potential, but they are not part of routine care.
• Patient‑centered communication remains essential: clearer risk estimates can guide shared decisions, distinct from proven gains in survival or quality of life.