Application of Molecular Profiling in Colorectal Cancer Surgery

Pei-Rong Ding, MD, PhD

Although molecular profiling has long been integrated into the systemic therapy of metastatic colorectal cancer, it did not arouse enough attention in colorectal cancer surgery until Cercek's study showing that microsatellite instability-high (MSI-H) rectal cancer might be cured by anti-PD-1 therapy. With the advance of precision medicine, we are getting closer to understand the nature of colorectal cancer, the relationship between molecular profiling and phenotype, and its impact on surgical management of colorectal cancer.

In this volume of Clinics in Colon and Rectal Surgery we introduce the most common molecular features, either germline or somatic, and their impact on the surgical management of colorectal cancer. Our aim is to combine the available evidence from literature with the practical tips from experts in the field.

I am deeply grateful to all the authors who have kindly shared their wealth of knowledge and experience without reservation. Their up-to-date perspective will provide valuable instruction to the reader.

Dr. Wu Jiang from Sum Yat-Sen University Cancer Center starts off the edition by providing a detailed review of the comprehensive management of Lynch syndrome, including screening, treatment, surveillance, and prevention. He also introduces the experience of management of Lynch syndrome from Sun Yat-Sen University Cancer Center.

Dr. Ying Yuan from The Second Affiliated Hospital of Zhejiang University School of Medicine introduces the experience of colorectal polyposis syndrome screening in Chinese population, with special attention on strategy of screening and new predisposing genes of polyposis syndrome.

Dr. Tianqi Zhang and Dr. Yue Xu from Fudan University Shanghai Cancer Center provide a detail update on surgical management of familial adenomatous polyposis (FAP), including timing of prophylactic surgery, extent of surgery, and function preservation.

Dr. Wangjun Yang from Sum Yat-Sen University Cancer Center provides a comprehensive perspective on the update on FAP-associated desmoid tumor, with special attention on surgery, active surveillance, and medical management.

Dr. Zuxin Xu and Dr. Guoli Gu from Air Force Medical Center have written an excellent treatise on the management of Peutz-Jeghers syndrome. From the biggest and most experienced center of treating Peutz-Jeghers syndrome in China, they provide a comprehensive and in-depth review of their extensive experience supported by the current literature.

Dr. Binyi Xiao from Sum Yat-Sen University Cancer Center discusses the update on neoadjuvant immunotherapy for MSI-H colorectal cancer, with special focus on nonoperative management in MSI-H colorectal cancer after immunotherapy, and provides prospect on nonoperative management in MSI-H colon cancer.

Dr. Yuye Gao and Dr. Aiwen Wu from Peking University Cancer Hospital & Institute introduce current status of organ preservation in microsatellite stable (MSS) rectal cancer and the emerging therapeutic strategies for organ preservation in MSS rectal cancer.

Dr. Wang Hui from the Sixth Affiliated Hospital of Sun Yat-sen University reviews the current status on cytoreductive surgery for peritoneal metastasis from colorectal cancer, focusing on the impact of molecular profiling on decision making and prognosis of cytoreductive surgery.

Dr. Kun Wang from Peking University Cancer Hospital & Institute discusses current status on metastasectomy for colorectal cancer with liver metastases, focusing on the impact of molecular profiling on decision making and prognosis of metastasectomy for colorectal cancer with liver metastases.

It has been an absolute privilege and honor for me to serve as a Guest Editor and to contribute to this volume of the journal. A special thanks to Dr. Steele for providing a platform for us to share this important work. To my wife Xin (mother and medical oncology) and my children Minze and Anyi, I am grateful, humbled, and proud.

Publication History

Article published online:
17 April 2023