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World J Gastrointest Surg. Dec 27, 2021; 13(12): 1597-1614
Published online Dec 27, 2021. doi: 10.4240/wjgs.v13.i12.1597
Patient-centered developments in colon- and rectal cancer with a multidisciplinary international team: From translational research to national guidelines
Karl-Heinrich Link, Marko Kornmann, Ludger Staib, Ernst-Dietrich Kreuser, Wilhelm Gaus, Erwin Röttinger, Peter Suhr, Catharina Maulbecker-Armstrong, Peter Danenberg, Kathleen Danenberg, Miriam Schatz, Silvia Sander, Zhen-Ling Ji, Jiang-Tao Li, Shu-You Peng, Reinhard Bittner, Hans Günther Beger, Benno Traub
Karl-Heinrich Link, Asklepios Tumor Center (ATC) and Surgical Center, Asklepios Paulinen Klinik, Wiesbaden 65197, Germany
Karl-Heinrich Link, Marko Kornmann, Ludger Staib, Ernst-Dietrich Kreuser, Wilhelm Gaus, Erwin Röttinger, Peter Suhr, Silvia Sander, Reinhard Bittner, Hans Günther Beger, Benno Traub, FOGT (Multidisciplinary Study Group on Oncology of Gastrointestinal Tumors), University of Ulm, Ulm 89081, Germany
Karl-Heinrich Link, Marko Kornmann, Ludger Staib, Hans Günther Beger, Benno Traub, Department of General and Visceral Surgery, University of Ulm, Ulm 89081, Germany
Wilhelm Gaus, Silvia Sander, Department of Biometry and Medical Documentation, University of Ulm, Ulm 89081, Germany
Erwin Röttinger, Peter Suhr, Department of Radiotherapy, University of Ulm, Ulm 89081, Germany
Catharina Maulbecker-Armstrong, Fachbereich Gesundheit, Medizinisches Management, Sozialversicherungssysteme, Internationales Versorgungsmanagement, e-Health, Technische Hochschule Mittelhessen, Giessen 35390, Germany
Peter Danenberg, Department of Biochemistry and Molecular Medicine, Keck-USC School of Medicine, Los Angeles, CA 90033, United States
Kathleen Danenberg, Norris Comprehensive Cancer Center, Keck-USC School of Medicine, Los Angeles, CA 90033, United States
Miriam Schatz, Private Practice for Psychology, Adelsdorf 91325, Germany
Zhen-Ling Ji, Department of General Surgery, Southeast University, Nanjing 210009, Jiangsu Province, China
Jiang-Tao Li, Shu-You Peng, Department of Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Reinhard Bittner, Surgical Clinic, Marienhospital, Stuttgart 70177, Germany
Author contributions: Link KH, Kornmann M, Staib L, Kreuser ED, Gaus W, Röttinger E, Suhr P, Schatz M, Sander S, Bittner R, Beger HG and Traub B contributed to the scientific progress as members of FOGT (Multidisciplinary Study Group on Oncology of Gastrointestinal Tumors); Gaus W and Sander S were responsible for the biometrical design and conduction of FOGT 1-5; Röttinger E and Suhr P were responsible for the design and co-conduction of FOGT-2; Maulbecker-Armstrong C was leading partner for the public campaign for preventive colonoscopies; Danenberg P and Danenberg K were partners in the design of translational research projects; Ji ZL, Li JT and Peng SY are in close research and clinical collaboration with the FOGT members; all coauthors contributed substantially to scientific developments and reviewed the paper which was written by Link KH and Traub B; Danenberg P performed language edition.
Conflict-of-interest statement: The authors declare no conflict of interest.
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: Karl-Heinrich Link, MD, Emeritus Professor, Surgeon, Asklepios Tumor Center (ATC) and Surgical Center, Asklepios Paulinen Klinik, Geisenheimer Str. 10, Wiesbaden 65197, Germany. k-h.link@asklepios.com
Received: May 10, 2021
Peer-review started: May 10, 2021
First decision: June 24, 2021
Revised: August 7, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: December 27, 2021
Processing time: 227 Days and 8.8 Hours
Abstract

Rarely, scientific developments centered around the patient as a whole are published. Our multidisciplinary group, headed by gastrointestinal surgeons, applied this research philosophy considering the most important aspects of the diseases “colon- and rectal cancer” in the long-term developments. Good expert cooperation/knowledge at the Comprehensive Cancer Center Ulm (CCCU) were applied in several phase III trials for multimodal treatments of primary tumors (MMT) and metastatic diseases (involving nearly 2000 patients and 64 centers), for treatment individualization of MMT and of metastatic disease, for psycho-oncology/quality of life involving the patients’ wishes, and for disease prevention. Most of the targets initially were heavily rejected/discussed in the scientific communities, but now have become standards in treatments and national guidelines or are topics in modern translational research protocols involving molecular biology for e.g., “patient centered individualized treatment”. In this context we also describe the paths we had to tread in order to realize our new goals, which at the end were highly beneficial for the patients from many points of view. This description is also important for students and young researchers who, with an actual view on our recent developments, might want to know how medical progress was achieved.

Keywords: Colon- and rectal cancer; Translational research; Interdisciplinary treatment; Personalized treatment; National guidelines

Core Tip: Interdisciplinary innovative research projects centered on the needs of patients with either colon- or rectal cancer were initiated under the leadership of gastrointestinal-surgeons. Phase III- and translational research trials were applied. Quality of life and disease prevention were involved. The projects initially were heavily criticized, but now are routine methods of treatment or goals of modern translational research. The paths may be interesting for the scientific community, and for young researchers, even students.