Colorectal Surgery

Omega-3 supplementation after CRC surgery improves recovery but not mortality

This meta-analysis pooled 34 RCTs including 2889 colorectal cancer surgery patients receiving perioperative omega-3 PUFA versus control nutrition. Omega-3 supplementation improved nutritional markers, including total protein and albumin, and enhanced T-cell subsets and CD4+/CD8+ ratio. Inflammatory markers such as procalcitonin, CRP, IL-6, and TNF-α were significantly reduced, with parallel improvements in Karnofsky performance status. Clinically, omega-3 reduced hospital stay, infectious complications, anastomotic leakage, and surgical-site infections, without any detectable mortality difference. A post hoc analysis suggested an optimal dose range of 0.16–0.30 g/kg/day, specifically derived from Chinese CRC populations. 1

Explainable deep-learning histopathology refines recurrence risk in stage II CRC

This multicenter retrospective study developed SurvFinder, a deep-learning framework analyzing 6950 H&E slides from 1604 stage II colorectal cancer patients. The model identified tertiary lymphoid structures (TLSs), especially peripheral and mature TLSs, as key prognostic features for relapse-free survival. Across four cohorts, TLS-based predictions achieved AUROCs around 0.80 and outperformed traditional clinical prognostic parameters with an HR of 8.23. Explainable AI methods highlighted TLS characteristics influencing prognosis and adjuvant chemotherapy efficacy, supporting TLS as a histologic biomarker. The study is retrospective without prospective validation, but suggests AI-derived TLS metrics may guide adjuvant therapy decisions after curative resection. 2

Tucatinib–trastuzumab shows durable benefit in HER2+, RAS WT metastatic CRC

The phase 2 MOUNTAINEER trial evaluated tucatinib plus trastuzumab in 84 patients with chemotherapy-refractory, HER2+, RAS wild-type unresectable or metastatic CRC. The confirmed objective response rate was 39.3%, with a median response duration of 15.2 months, indicating durable disease control. Median progression-free and overall survival were 8.1 and 23.9 months, respectively, for this heavily pretreated population. Efficacy was consistent across central HER2 testing methods, and no clear impact of co-occurring biomarker alterations on response was observed. Treatment discontinuations for toxicity were uncommon, with no treatment-emergent deaths, supporting this chemotherapy-free regimen as a tolerable option. 3

Renal-clearable NIR-II dye enables prolonged non-invasive ureter visualization

This biomaterials study developed IR-FEP1000, a renal-clearable NIR-II fluorescent dye cluster for intraoperative ureter imaging. Intravenous IR-FEP1000 was excreted renally, providing high-resolution, photostable ureteral visualization over a prolonged imaging window. In preclinical models, the dye enabled non-invasive detection of ureter transection, ligation, and clamping, facilitating early recognition of injury scenarios. Combined with CO-1080 and Er-NPs, IR-FEP1000 supported multiplex NIR-II imaging of peritoneal metastases, ureters, and intestines during simulated surgery. These data suggest future potential to reduce ureteral injury and improve tumor clearance in complex colorectal cancer operations. 4