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Colorectal Cancers: New Approach to Their Pathology, Diagnosis and Therapy

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Guest Editor
Department of Surgical Clinical Sciences, Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
Interests: colorectal cancers; thymoma; pulmonary medicine; malignant pleural effusion; video-assisted thoracic surgery; mesothelioma; transthoracic biopsy; bronchoscopy; cancer malnutrition; dietary intervention
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Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is the third most prevalent cancer in Poland, with its incidence increasing. Its progression typically spans several years, and its early warning signs encompass rectal bleeding, changes in bowel habits, and abdominal pain. Numerous risk factors for CRC can be mitigated through lifestyle modifications, and regular fecal occult blood tests and decennial colonoscopies have been shown to effectively reduce the incidence and mortality rates of CRC. In addition, advances in surgical techniques and the introduction of novel oncological drugs have enhanced the quality of life of patients and boosted their survival rates. Thorough preoperative preparations are crucial for minimizing complications and optimizing surgical outcomes. CRC patients are also at a higher risk of developing anxiety and depression.

This Special Issue welcomes original research papers, authoritative and up-to-date reviews, and commentaries on the following topics:

  • Novel drugs and surgical techniques for therapy against colorectal disease.
  • Molecular mechanisms of anti-colorectal cancer or cancer-preventive drugs.
  • In vitro, in vivo, and clinical studies related to colorectal cancer.
  • The usage of surgical methods in conjunction with chemotherapeutic drugs.
  • Challenges and innovative approaches to anti-colorectal cancer drug development.
  • Novel strategies for colorectal cancer prevention and intervention.
  • The production of anti-colorectal cancer agents using biotechnology.
  • Pharmacokinetic and pharmacogenomic studies on anti-colorectal cancer drugs.

Dr. Mariusz Chabowski
Guest Editor

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Keywords

  • occult blood test
  • colorectal cancer
  • colonoscopy
  • rectal bleeding
  • abdominal pain
  • hemicolectomy
  • novel oncological drugs

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Published Papers (2 papers)

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Research

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23 pages, 4922 KB  
Article
Robot-Assisted Colorectal Cancer Surgery Mitigates Early Postoperative Immunosuppression and Angiogenesis
by Mariusz G. Fleszar, Marek Zawadzki, Paulina Fortuna, Iwona Bednarz-Misa, Izabela Krauze, Kamila Maciejewska, Jakub Klekowski, Mariusz Chabowski, Wojciech Witkiewicz and Małgorzata Krzystek-Korpacka
Int. J. Mol. Sci. 2025, 26(20), 10041; https://doi.org/10.3390/ijms262010041 - 15 Oct 2025
Viewed by 1014
Abstract
Minimally invasive surgery is known to lessen postoperative stress and complications compared with open procedures, yet its molecular effects on immunity and cancer-related mechanisms remain unclear. This study examined immune and inflammatory responses after robot-assisted (RS) versus open (OS) colorectal cancer surgery. Sixty-one [...] Read more.
Minimally invasive surgery is known to lessen postoperative stress and complications compared with open procedures, yet its molecular effects on immunity and cancer-related mechanisms remain unclear. This study examined immune and inflammatory responses after robot-assisted (RS) versus open (OS) colorectal cancer surgery. Sixty-one patients (RS = 30; OS = 31) were enrolled. Blood samples were collected before surgery and at 8, 24, and 72 h post-incision. Cytokines, growth factors, and prostanoids were measured using multiplex immunoassays and mass spectrometry to assess systemic immune and inflammatory changes. Surgery type markedly influenced perioperative immune profiles. RS induced stronger activation of Th1-associated cytokines, including IFNγ and IP-10, suggesting enhanced cellular immune responsiveness. In contrast, Th2 cytokines and other immunosuppressive mediators—such as IL-4, IL-10, and G-CSF—showed smaller or transient increases after RS, whereas OS triggered broader and more sustained elevations. Angiogenic factors (VEGF-A, PDGF-BB, FGF2) rose significantly after OS but remained comparatively lower and returned to baseline faster after RS, indicating a weaker proangiogenic response. Similarly, postoperative surges in prostaglandins linked to inflammation and tumor progression (PGE2, PGF2α) were blunted and resolved earlier following RS. Overall, the robotic approach was associated with reduced inflammatory and immunosuppressive activity, faster recovery of immune balance, and diminished biochemical signals favoring angiogenesis and potential tumor regrowth, suggesting a potential protective effect against pathogens and cancer-promoting mechanisms after colorectal tumor resection. Full article
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Review

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21 pages, 1548 KB  
Review
From CMS to iCMS/IMF: Developing Roadmap to Precision Therapy in Colorectal Cancer
by Sungwon Jung
Int. J. Mol. Sci. 2025, 26(22), 11086; https://doi.org/10.3390/ijms262211086 - 16 Nov 2025
Viewed by 503
Abstract
Colorectal cancer (CRC) classification has progressed from consensus molecular subtypes (CMS) to epithelial–intrinsic consensus molecular subtypes (iCMS) and the layered intrinsic subtype-MSI-fibrosis (IMF) system that combines intrinsic state, MSI status, and fibrosis. This article reviews biological underpinnings of iCMS/IMF, their relationships to tumor-microenvironment [...] Read more.
Colorectal cancer (CRC) classification has progressed from consensus molecular subtypes (CMS) to epithelial–intrinsic consensus molecular subtypes (iCMS) and the layered intrinsic subtype-MSI-fibrosis (IMF) system that combines intrinsic state, MSI status, and fibrosis. This article reviews biological underpinnings of iCMS/IMF, their relationships to tumor-microenvironment crosstalk, and how single-cell and spatial transcriptomics refine therapeutic stratification by resolving tumor microenvironment heterogeneity and its impact on fibrosis. Prognostic and therapeutic implications are covered, including PD-1 blockade in MSI-high (MSI-H), MAPK-directed therapy in BRAF-mutant disease, and EGFR targeting in selected RAS wild-type (WT) left-sided tumors, and we suggest decision points specifically informed by the activity of the fibrosis axis. A step-by-step procedure is presented for the analysis of bulk and single-cell RNA and formalin-fixed, paraffin-embedded (FFPE) resources, along with open-source tools and reporting standards to make iCMS/IMF calling reproducible in clinics and trials. Future outlooks are outlined with near-term biomarker–drug hypotheses for microsatellite-stable (MSS)-iCMS3 and high fibrosis tumors and key gaps to close for clinical translation. This review outlines a roadmap for precision medicine in colorectal cancer by leveraging the iCMS/IMF framework to integrate pathology and digital pathology, molecular diagnostics, and therapy mapping with FAP-targeted imaging and therapy. Full article
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