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Cancers
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The Survival of Colon and Rectal Cancer (2nd Edition)
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The Survival of Colon and Rectal Cancer (2nd Edition)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 15 January 2026 | Viewed by 629

Special Issue Editor

Prof. Dr. Susanne Merkel

E-Mail Website
Guest Editor
Department of General and Visceral Surgery, Friedrich-Alexander-University (FAU) Erlangen-Nuremberg, 91054 Erlangen, Germany
Interests: colorectal cancer; tumor classification; cohort studies; prognostic factors; quality management; late recurrences; quality of life
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the Special Issue titled “The Survival of Colon and Rectal Cancer”.

Colorectal cancer is the third most common cancer in men and the second most common cancer in women. In 2020, there were more than 1.9 million new cases of colorectal cancer. With increasing life expectancy, we are seeing more elderly patients. However, the number of young patients under 50 is also increasing. Survival rates have improved due to improved surgical procedures such as total mesorectal excision (TME) and complete mesocolic excision (CME), as well as multidisciplinary approaches, especially for advanced carcinomas. During recent decades, standardisation of treatment has been an important tool to improve survival. Today, with increasing therapeutic options and the results of prognostic factor research, the possibilities to individualise therapy are increasing. Both undertreatment and overtreatment should be avoided. However, not only is the length of survival time important, but also the quality of life of the patients.

The aim of this Special Issue is to (a) show the current results of surgical and multidisciplinary treatment of colorectal cancer with regard to recurrence and survival, (b) identify prognostic factors, (c) highlight future possibilities to improve prognosis, and (d) discuss individualisation versus standardisation in the treatment of colorectal carcinomas.

I look forward to receiving your contributions.

Prof. Dr. Susanne Merkel
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • colorectal cancer
  • colorectal cancer surgery
  • multidisciplinary treatment
  • survival
  • prognostic factors
  • distant metastasis
  • locoregional recurrences
  • standardisation
  • individualisation

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Published Papers (1 paper)

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Research

18 pages, 4478 KB  
Article
Tumour-Infiltrating Lymphocytes, Tumour Cell Density, and Response to Neoadjuvant Short-Course Radiotherapy in Rectal Cancer: A Translational Sub-Study from the MRC CR07 Clinical Trial
by Jonathan P. Callaghan, Ross Jarrett, Alice C. Westwood, Jon Laye, Philip Quirke, Derek R. Magee, Daniel Bottomley, David Sebag-Montefiore, Lindsay Thompson, Angela Meade, Heike I. Grabsch and Nicholas P. West
Cancers 2025, 17(18), 3040; https://doi.org/10.3390/cancers17183040 - 17 Sep 2025
Viewed by 271
Abstract
Background: Rectal cancer is common and frequently treated with neoadjuvant radiotherapy prior to surgery to reduce the risk of tumour recurrence. However, the therapeutic benefits and side effects of radiotherapy can vary between patients, and there are currently no validated biomarkers to [...] Read more.
Background: Rectal cancer is common and frequently treated with neoadjuvant radiotherapy prior to surgery to reduce the risk of tumour recurrence. However, the therapeutic benefits and side effects of radiotherapy can vary between patients, and there are currently no validated biomarkers to predict treatment response. Tumour cell density (TCD) and tumour-infiltrating lymphocyte (TIL) density are proven prognostic biomarkers in colorectal cancer; however, their utility in predicting radiotherapy response remains unclear. We assessed the prognostic and predictive value of TCD and TIL density in rectal cancer patients treated with radiotherapy. Methods: TCD was quantified using a manual point-counting method in 253 pre-treatment biopsies and across the entire tumour area of 569 resection specimens from the MRC CR07 clinical trial, which randomised patients to either neoadjuvant short-course radiotherapy (SCRT) or straight to surgery (control). TIL density was measured in 102 biopsies and matched resection specimens (73 SCRT, 29 control) across different tumour areas using deep learning-based cell detection in MIM (HeteroGenius Ltd., Leeds, UK). Cutoffs for low/high-TCD and TIL density were both pre-defined and derived from survival data using the survminer R package. Survival analyses were performed to evaluate the predictive and prognostic value of TCD/TIL in relation to overall and cancer-specific survival. Results: TCD in the resection specimens was lower in the SCRT group (19.9%, IQR 12.9–26.7%) than the control group (34.3%, IQR 27.7–40.5%, p < 0.001). In control resections, low-TCD was associated with a higher risk of all-cause mortality (HR 2.20, 95% CI 1.41–3.44, p < 0.001) and cancer-related death (HR 2.69, 95% CI 1.41–5.13, p = 0.0026). In contrast, after SCRT, low resection TCD was associated with a reduced risk of death (HR 0.63, 95% CI 0.40–0.98, p = 0.04). In the SCRT group, low biopsy TCD prior to radiotherapy was associated with a reduced risk of cancer-related death (HR 0.34, 95% CI 0.13–0.89, p = 0.028). Across both trial arms, TIL density was higher in pre-treatment biopsies than resections (2492 vs. 1304/mm2, p < 0.001). Low biopsy TIL density was associated with an increased risk of all-cause mortality (HR 2.43, 95% CI 1.24–4.76, p = 0.01). The SCRT group had lower TIL density in the resection compared with controls (1210 vs. 1615/mm2, p < 0.001), and low resection TIL density across the whole tumour area was associated with a higher risk of death (HR 2.55, 95% CI 1.11–5.87, p = 0.027). Conclusions: Our findings support the role of TCD and TIL density as quantitative biomarkers in rectal cancer patients. TCD can be used to assess the degree of response to radiotherapy, and contrasting survival associations are observed between straight-to-surgery and SCRT-treated patients. This study raises the possibility of using TCD as both a prognostic and predictive biomarker. TIL density failed to show predictive value but demonstrated expected prognostic associations. Full article
(This article belongs to the Special Issue The Survival of Colon and Rectal Cancer (2nd Edition))
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