Highly sensitive and specific immunocytological and molecular methods now enable the detection of disseminated (DTC) in bone marrow of cancer patients at the single cell level years before the occurrence of distant overt metastases. This information might be useful to assess individual prognosis and stratify patients at risk to systemic adjuvant anti-cancer therapies. Although most data on the prognostic value of DTC are available for breast cancer, several single institution studies including patients with colon, lung, prostate, esophageal, gastric, pancreatic, ovarian, and head and neck carcinomas have also documented an association between the presence of DTC at primary surgery and subsequent metastatic relapse. Moreover, the molecular characterization of DTC in bone marrow has provided new insights into the complex biology of bone metastasis. Here, we will summarize the current knowledge about the specific biological properties of DTC in bone marrow, and discuss the clinical relevance of DTC detection in cancer patients with regard to improved individualized therapeutic management.
