Loading
Cancer Genomics and Diagnostics / Colorectal Cancer Surgical Treatments / Genetic Factors in Colorectal Cancer · Journal article
International Journal of Molecular Sciences · August 14, 2026
A consensus or society position rather than new primary data.
This is a narrative review that characterizes the current landscape of personalized perioperative CRC management based on tumor biology (MSI/MMR status) and anatomical site (colon versus rectum), organising evidence into four clinically relevant subgroups. The authors acknowledge that evidence maturity ranges from established phase III standards to guideline-endorsed single-arm approaches and investigational strategies requiring prospective validation, but do not present systematic strength of evidence ratings or new efficacy data.
Journal article.
Four clinically relevant subgroups now guide CRC perioperative decision-making: MSS/pMMR colon cancer, MSI-H/dMMR colon cancer, MSS/pMMR rectal cancer, and MSI-H/dMMR rectal cancer In MSI-H/dMMR colon cancer, immune checkpoint inhibitor therapy has shown marked activity in both adjuvant and neoadjuvant settings In MSS/pMMR rectal cancer, total neoadjuvant therapy, selective omission of pelvic radiotherapy, and watch-and-wait strategies are redefining treatment sequencing and organ preservation
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
A narrative review synthesizing evolving paradigms in CRC perioperative management across multiple tumor biology and anatomical subgroups, ranging from established phase III evidence to investigational strategies, without presenting new primary data.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
What is missing. This record has no reported figures. That is a gap in the analysis, not a judgement about the study.
Perioperative treatment for colorectal cancer (CRC) is undergoing a paradigm shift from uniform cytotoxic regimens toward strategies guided by tumor location, microsatellite instability (MSI)/mismatch repair (MMR) status, and recurrence risk. Four clinically relevant subgroups now shape decision-making: microsatellite stable (MSS)/proficient MMR (pMMR) colon cancer, microsatellite instability-high (MSI-H)/deficient MMR (dMMR) colon cancer, MSS/pMMR rectal cancer, and MSI-H/dMMR rectal cancer. In MSS/pMMR colon cancer, adjuvant therapy is being refined through risk-adapted treatment duration and selective use of neoadjuvant chemotherapy. In MSS/pMMR rectal cancer, total neoadjuvant therapy, selective omission of pelvic radiotherapy, and watch-and-wait strategies are redefining treatment sequencing and organ preservation. In MSI-H/dMMR colon cancer, immune checkpoint inhibitor (ICI) therapy has shown marked activity in both adjuvant and neoadjuvant settings. In MSI-H/dMMR rectal cancer, neoadjuvant ICI therapy is being explored as a non-operative organ preservation strategy. In parallel, circulating tumor DNA (ctDNA)-based minimal residual disease (MRD) assessment is emerging as a tool for postoperative escalation, de-escalation, and surveillance. Across these settings, the maturity of the evidence varies widely, ranging from established phase III standards to guideline-endorsed but still single-arm approaches and investigational strategies that require prospective validation before routine adoption. This review summarizes the current evidence and remaining challenges in biology-, site-, and risk-adapted perioperative management of CRC.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.