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Presence of metastasis in colorectal cancer (CRC) is prognostic and impacts treatment decision making. 20-30% of patients with histologically negative LNs relapses and dies from disseminated disease, undetectable at the time of primary surgery, suggesting the presence of occult nodal metastases, not identified by standard pathological analysis, and/or early blood dissemination. A plethora of studies has provided evidence about the prognostic impact of molecular alterations in neoplasia, particularly they strongly support the role of cancer-related epigenetic modifications for early diagnosis prognosis, follow-up and therapy response. Indeed Hypermethylated Tumor Suppressor Genes have been proposed as intriguing biomarkers for studying the presence of neoplastic cells in several body compartments (lymph nodes), and body fluids (serum/plasma, urine, stools, etc).
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