Dear Colleagues:
As the New Year bell is about to ring, 2025 has been a fruitful year for clinical research in colorectal cancer, and 2026 is highly anticipated.
Early Screening for Colorectal Cancer
Notably, Galleri has increased the sensitivity of colorectal cancer screening to 92% and specificity to 99%. With subsequent price reductions and wider accessibility, it is expected to enable early detection in more cancer patients.
Similar to the early detection of blood tests, the detection of minimal residual disease(MRD) detection of colorectal cancer after surgery also received more clinical evidence in 2025, which may change the current principle of relying on postoperative pathological staging to develop postoperative adjuvant therapy, and detect recurrence or metastasis earlier.
Neoadjuvant Therapy for Colorectal Cancer
Particularly in MSS-type locally advanced low rectal cancer, multiple clinical studies on neoadjuvant chemoradiotherapy combined with immunotherapy have been reported in 2025. The complete response rate (including clinical complete response + pathological complete response) has exceeded 40%, significantly improving the anus-preserving rate. Future efforts will focus on long-term monitoring of patients undergoing "wait and watch" strategies to ensure the safety of this surgery-sparing approach. Additionally, the combined application of more immunotherapy sensitization methods (such as fecal microbiota transplantation) is expected to further enhance the feasibility of avoiding surgery for low rectal cancer.
Surgical Treatment of Colorectal Cancer
Da Vinci-assisted surgery and transanal total mesorectal excision(TaTME) for rectal cancer have gained more recognition from clinical evidence. A notable trend is the increasing application of data-based AI methods in the surgical procedures of colorectal cancer. A study published in Nature Medicine in September showed that using an AI prediction model can reduce surgical complications by 36.5% (23.7% vs. 37.3%, OR=0.53). In the future, new technologies such as EndoSCell® for precise intraoperative identification of tumor cells will also lower the recurrence rate of rectal cancer while improving the anal preservation rate.
Treatment of Metastatic Colorectal Cancer
For metastatic colorectal cancer with no curative opportunity, beyond DS-8201 for Her2-positive tumors, agents targeting KRAS G12C, and drugs for BRAF V600E mutations, targeted therapies for KRAS G12D and G12V mutations have entered Phase II clinical trials. These advancements provide more treatment options for refractory metastatic colorectal cancer.
Future Outlook
In the future, we should not overlook the value of cancer cellular adoptive therapies. The first era of cancer treatment was dominated by chemotherapy, the second by targeted therapy, and the third by immunotherapy—so what will the next era bring? Regardless, various treatment modalities will not exist in isolation but will be used in combination, including all types of surgical procedures.
This Special Issue aims at gathering original research, and reviews focusing on innovative surgical techniques, and intelligent technologies of colorectal cancer.
We wish Surgical Technology International to report more high-quality research in the field of colorectal cancer, focusing on new surgical technologies, in the coming year. We also hope that through the joint efforts of all, colorectal cancer patients will achieve higher cure rates and improved quality of life.