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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2026; 32(5): 115009
Published online Feb 7, 2026. doi: 10.3748/wjg.v32.i5.115009
Published online Feb 7, 2026. doi: 10.3748/wjg.v32.i5.115009
Molecular profiling-directed individualized adjuvant therapy in colorectal cancer: Bridging consensus guidelines to clinical disparities
Xiao-Fei Cheng, Department of Colorectal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Author contributions: Cheng XF was responsible for all aspects of this work, including conceptualization and design, literature search and analysis, methodology validation, manuscript drafting, revision and editing, visualization integration, and final approval of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiao-Fei Cheng, MD, PhD, Associate Chief Physician, Department of Colorectal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Raod, Hangzhou 310003, Zhejiang Province, China. xfcheng@zju.edu.cn
Received: October 9, 2025
Revised: November 14, 2025
Accepted: December 19, 2025
Published online: February 7, 2026
Processing time: 115 Days and 18.8 Hours
Revised: November 14, 2025
Accepted: December 19, 2025
Published online: February 7, 2026
Processing time: 115 Days and 18.8 Hours
Core Tip
Core Tip: Molecular profiling, including mismatch repair deficiency/microsatellite instability, circulating tumor DNA (ctDNA), and consensus molecular subtypes, refines risk stratification and guides personalized adjuvant therapy in colorectal cancer. Persistent gaps between guidelines and practice stem from technical variability, limited evidence for novel strategies (e.g., ctDNA-guided escalation), and health economic disparities. Bridging these requires integrated artificial intelligence-multiomics decision tools, dynamic ctDNA monitoring, and health policy reforms supporting equitable implementation.