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Colorectal Cancer: Early Detection, Treatment Advances and Patient Outcomes
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Colorectal Cancer: Early Detection, Treatment Advances and Patient Outcomes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: 20 July 2026 | Viewed by 2798

Editors

Dr. Damiano Caputo

E-Mail Website
Guest Editor
Research Unit of General Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
Interests: pancreatic cancer; pancreatic surgery; HPB surgery; robotic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Roberto Cammarata

E-Mail Website
Guest Editor
Operative Research Unit of General Surgery, Fondazione Policlinico Universitario, Campus Bio-Medico, 00128 Rome, Italy
Interests: pancreatic cancer; pancreatic surgery; HPB surgery; robotic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Federica Giordano

E-Mail Website
Guest Editor Assistant
Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, 00128 Rome, Italy
Interests: colorectal cancer; colorectal surgery; pancreatic cancer; pancreatic surgery; hepato-pancreato-biliary (HPB) surgery; robotic surgery

Special Issue Information

Dear Colleagues,

Colorectal cancer (CRC) is the third most common malignancy worldwide and currently represents a leading cause of morbidity and mortality in the general population, accounting for more than 10% of all cancer-related deaths. Despite its elevated mortality, survival rates seem to be steadily increasing, primarily owing to improvements in screening and treatment options.

Lately, research has primarily been directed at understanding the molecular mechanisms underlying CRC tumorigenesis and progression, along with its genetic profiles and associated risk factors. Progress has also been made in early diagnosis and treatment, with the development of multimodal screening programs and innovative targeted therapies that are revolutionizing the care of CRC and raising hope for better outcomes: CRC is indeed one of the few malignancies where early detection and prevention strategies significantly improve survival rates.

This Special Issue aims to provide a comprehensive understanding of the current state of colorectal cancer, spanning from underlying pathogenesis and risk factors to the latest treatment advancements and potential future directions for research and care.

Dr. Damiano Caputo
Dr. Roberto Cammarata
Guest Editors

Dr. Federica Giordano
Guest Editor Assistant

Manuscript Submission Information

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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-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine 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 2600 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
  • early detection
  • prevention
  • innovation
  • screening
  • precision medicine
  • biomarkers
  • genetic profile

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Published Papers (3 papers)

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Research

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25 pages, 2313 KB  
Article
Ten-Year Outcomes in Colorectal Cancer—Competing Risks and Patient Vulnerability: A Prospective Multicenter Observational Study
by Marilina García-Aranda, Desireé Martín-García, Janire Gallejones-Eskubi, Eloísa Urrechaga, Josefa Ferreiro, Vicente Portugal, Isabel Portillo, Marta Jiménez-Toscano, Maria Jose Legarreta, José María Quintana, Maximino Redondo and Urko Aguirre
J. Clin. Med. 2026, 15(11), 4389; https://doi.org/10.3390/jcm15114389 - 5 Jun 2026
Viewed by 305
Abstract
Background: As survival after colorectal cancer (CRC) has improved, an increasing proportion of patients live beyond five years, making long-term outcomes increasingly relevant. In addition to cancer-related mortality, survivors remain at risk of death from other causes influenced by clinical and psychosocial vulnerabilities. [...] Read more.
Background: As survival after colorectal cancer (CRC) has improved, an increasing proportion of patients live beyond five years, making long-term outcomes increasingly relevant. In addition to cancer-related mortality, survivors remain at risk of death from other causes influenced by clinical and psychosocial vulnerabilities. Methods: We conducted a 10-year prospective cohort study including 838 patients with stage I–IV CRC treated in public hospitals in the Basque Country (Spain). Patients were recruited between November 2010 and December 2012 and followed for up to 10 years after surgery. Clinical, sociodemographic, lifestyle, and patient-reported outcomes were collected. Competing risk regression models (Fine-Gray) were used to estimate sub-distribution hazard ratios (sHRs) for CRC-specific and non-CRC mortality, stratified by tumor site and sex. Results: After 10 years, 40% of patients had died, with 66% of deaths attributable to CRC and 34% to other causes. CRC-specific mortality was mainly driven by tumor-related factors, including advanced stage (stage IV: sHR 7.18, p < 0.001) and residual disease after surgery (R1/R2: sHR 2.68; p < 0.001), with larger effect sizes observed in rectal cancer. In contrast, non-CRC mortality was associated with patient vulnerability, including age ≥75 years (sHR 3.57, p < 0.001), absence of adjuvant chemotherapy (sHR 5.59, p < 0.001), anemia, alcohol consumption, and poor functional status. Patients with rectal cancer and women reported poorer baseline quality of life. Sex-stratified analyses suggested differential patterns of vulnerability, with psychosocial and quality-of-life-related factors appearing more relevant in women, whereas lifestyle and clinical factors appeared more prominent in men. Conclusions: Long-term mortality in CRC reflects the interplay between tumor-related factors and patient vulnerability. Competing risk models allow a more accurate characterization of cause-specific outcomes and may help identify high-risk subgroups for tailored follow-up and management strategies. Full article
(This article belongs to the Special Issue Colorectal Cancer: Early Detection, Treatment Advances and Patient Outcomes)
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15 pages, 895 KB  
Article
Efficacy, Safety, and Survival Outcomes of Immune Checkpoint Inhibitors in Patients with Mismatch Repair-Deficient Colorectal Cancer: A Retrospective, Multicenter Study
by Mehmet Cihan İcli, Deniz Can Guven, Arif Akyildiz, Ali Fuat Gürbüz, Nargiz Majidova, Mehmet Mutlu Kıdı, Hakan Kosku, Elif Sahin, Tugce Kubra Gunes, Mustafa Seyyar, Elvina Almuradova, Pervin Can Sancı, Burak Bilgin, Ismail Oguz Kara, Mehmet Artac, Ömer Dizdar and Suayib Yalcin
J. Clin. Med. 2026, 15(4), 1554; https://doi.org/10.3390/jcm15041554 - 16 Feb 2026
Viewed by 994
Abstract
Background: Microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer (CRC) accounts for approximately 5% of metastatic CRC cases. Immune checkpoint inhibitors (ICIs) are the standard of care based on pivotal clinical trials; however, real-world data, particularly from low-resource countries, remain scarce, [...] Read more.
Background: Microsatellite instability-high (MSI-H) or mismatch repair-deficient (dMMR) colorectal cancer (CRC) accounts for approximately 5% of metastatic CRC cases. Immune checkpoint inhibitors (ICIs) are the standard of care based on pivotal clinical trials; however, real-world data, particularly from low-resource countries, remain scarce, and prognostic factors are not yet fully defined. Therefore, we evaluated the efficacy and the safety of ICIs in a multi-center cohort. Methods: This multi-center retrospective study included 45 patients treated with ICIs across six oncology centers in Türkiye between June 2017 and December 2024. Patients received either anti–PD-1/PD-L1 monotherapy or anti–CTLA-4–based combination therapy. Key clinical variables and 1-, 2-, and 3-year OS and PFS outcomes were systematically collected. Results: The median age was 61 years, and most patients (75.6%) received ICIs in later treatment lines. After a median follow-up of 24.1 months, median OS and PFS were not reached. The estimated 1-, 2-, and 3-year OS rates were 82%, 76.1%, and 76.1%; PFS rates were 75.6%, 67.5%, and 67.5%, respectively. In multivariate analysis, an ECOG < 1 (HR: 0.072; 95% CI: 0.012–0.453; p = 0.005), a metastatic burden of fewer than two sites (HR: 0.211; 95% CI: 0.052–0.860; p = 0.030), and absence of antibiotic exposure within one month prior to immunotherapy initiation (HR: 0.145; 95% CI: 0.034–0.614; p = 0.009) were independently associated with improved overall survival. For PFS, ECOG < 1 (HR: 0.172; 95% CI: 0.052–0.573; p = 0.004), a metastatic burden of fewer than two sites (HR: 0.248; 95% CI: 0.078–0.788; p = 0.018), and no recent antibiotic exposure (HR: 0.209; 95% CI: 0.064–0.687; p = 0.010) remained independent predictors of prolonged survival. Conclusions: We observed overall survival outcomes similar to those reported in phase III clinical trials of immunotherapy in MSI-H/dMMR colorectal cancer, despite a substantial proportion of patients receiving immunotherapy in later lines of treatment. These findings support immune checkpoint inhibitors as the standard of care for MSI-H/dMMR metastatic colorectal cancer and emphasize the importance of improving access to immunotherapy, particularly in low-resource settings. Full article
(This article belongs to the Special Issue Colorectal Cancer: Early Detection, Treatment Advances and Patient Outcomes)
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Review

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21 pages, 359 KB  
Review
Robotic-Assisted Surgery for Colorectal Cancer Treatment in 2026: An Updated Narrative Review
by Cammarata Roberto, La Vaccara Vincenzo, Catamerò Alberto, Bani Lucrezia, Castagliuolo Pierpaolo, Giordano Federica, Castagna Vittoria, Coppola Roberto and Caputo Damiano
J. Clin. Med. 2026, 15(10), 3714; https://doi.org/10.3390/jcm15103714 - 12 May 2026
Cited by 1 | Viewed by 1001
Abstract
Background/Objectives: Colorectal cancer (CRC) is one of the most commonly diagnosed malignancies worldwide and a leading cause of cancer-related mortality. Surgical resection remains the cornerstone of curative treatment. Over the past two decades, robotic-assisted surgery has emerged as an evolution of minimally [...] Read more.
Background/Objectives: Colorectal cancer (CRC) is one of the most commonly diagnosed malignancies worldwide and a leading cause of cancer-related mortality. Surgical resection remains the cornerstone of curative treatment. Over the past two decades, robotic-assisted surgery has emerged as an evolution of minimally invasive surgery, aiming to overcome several limitations of conventional laparoscopy. This narrative review summarizes the current state of the art of robotic surgery in CRC. Methods: A narrative review of the literature was conducted using PubMed/MEDLINE and Scopus databases, focusing on publications from 2015 to 2026. The review provides an overview of robotic platforms and summarizes the available clinical evidence. Priority was given to randomized controlled trials, meta-analyses, large observational studies, and clinical practice guidelines. The review focuses on major commercially available robotic systems, including the da Vinci®, Hugo™ RAS, and Versius® platforms, as well as emerging robotic technologies. Results: Robotic colorectal surgery showed potentially favorable perioperative and oncological outcomes compared with laparoscopy. In rectal cancer, robotic approaches were associated with improved total mesorectal excision quality, lower conversion rates, and improved postoperative functional outcomes. Emerging evidence also suggested potential improvements in disease-free survival and local disease control following robotic rectal surgery. In colon cancer, robotic colectomy were associated with lower conversion rates, reduced blood loss, and faster postoperative recovery, with comparable long-term oncological outcomes. However, robotic procedures showed longer operative times and higher procedural costs. Conclusions: Robotic colorectal surgery appears to be a safe and effective minimally invasive approach, particularly in rectal cancer surgery. The development of new robotic platforms and increasing market competition may improve cost sustainability and expand its future role in colorectal cancer management. Full article
(This article belongs to the Special Issue Colorectal Cancer: Early Detection, Treatment Advances and Patient Outcomes)
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