From October 2nd to 4th, 2024, the 43rd Congress of the European Society of Surgical Oncology (ESSO) was held in Antwerp, Belgium. As one of the three major European oncology societies, alongside the European Society for Medical Oncology (ESMO) and the European Society for Radiotherapy and Oncology (ESTRO), ESSO organizes the largest annual academic conference on surgical oncology in Europe, inviting leading figures in surgical oncology from around the world to provide a great platform for global scholars to exchange ideas. The theme of this year's congress was Surgical Oncology Tomorrow: Innovation & Education.

Professor Li Xinxiang from Fudan University Shanghai Cancer Center (FUSCC) was invited to present an oral report on the TORCH-E research findings at the congress. This study, led by Professor Li Xinxiang and Professor Zhang Zhen, with specific implementation by Professor Xia Fan, is a Phase II clinical trial of short-course radiotherapy combined with immunotherapy and chemotherapy as neoadjuvant therapy for early rectal cancer. This innovative therapy, based on short-course radiotherapy combined with immunotherapy and chemotherapy, is used as neoadjuvant therapy for patients with low early rectal cancer with intact mismatch repair or microsatellite stable (pMMR/MSS) status. It significantly improves the complete response (CR) rate to 88.5% and the organ preservation (OP) rate to 73.1%, providing a promising new treatment option for rectal cancer patients to preserve their anus. This research has received widespread attention from experts at the congress and contributed Chinese wisdom and elegance to the global treatment of colorectal cancer.

Professor Li Xinxiang (first on the left) presenting a report at the conference.

Professor Li Xinxiang presenting at the ESSO conference venue.

Currently, radical surgery is considered the standard treatment for stage I-II rectal cancer. However, for patients with low-lying early-stage rectal cancer, there may be better treatment options to improve the probability of anus preservation and protect anal function. Relevant studies have shown that preoperative radiotherapy and chemotherapy combined with PD-1 inhibitor neoadjuvant therapy demonstrates good tumor regression effects in patients with locally advanced rectal cancer, facilitating organ preservation. Therefore, this combination therapy deserves investigation in early-stage rectal cancer. This study aims to explore the efficacy and safety of short-course radiotherapy (SCRT) combined with PD-1 inhibitor and chemotherapy (capecitabine + oxaliplatin, CAPOX) in the treatment of early-stage low-lying pMMR/MSS rectal cancer. The results of this study have frequently appeared at international conferences, including being selected for presentation at 2024 ESMO Congress, ASTRO Congress, and now orally presented at the ESSO Congress, further demonstrating the innovative value and great potential of this research.

Design of the study.

Furthermore, based on the promising results of the TORCH-E study, led by the colorectal cancer team at FUSCC and in collaboration with dozens of large hospitals in China, another prospective, multi-center clinical study (TORCH-E2) has been initiated for further exploration, with the aim of benefiting more patients with low rectal cancer.

Meanwhile, at the annual meeting of the Laparoscopic Surgery of Gastrointestinal Cancer Committee of the Shanghai Anti-Cancer Association this year, Shanghai International Colorectal Surgery Training and Exchange Center (SICSTEC) was officially established. The center is affiliated with the Pudong Campus of FUSCC, located in Shanghai Zhangjiang International Medical Science Park. Li Xinxiang, the chairman of the Laparoscopic Surgery of Gastrointestinal Cancer Committee of the Shanghai Anti-Cancer Association, concurrently serves as the director of the center. The establishment of SICSTEC aims to facilitate technical exchanges between colorectal surgery experts from China and around the world, as well as to provide training for overseas trainees, opening up a new space for mutual learning and exchange among global colorectal surgery professionals. As one of the largest colorectal cancer diagnosis and treatment centers in China, the Department of Colorectal Surgery, FUSCC, completed 5,231 radical surgeries for colorectal cancer in 2023 (ranking among the largest centers nationwide). Relying on the comprehensive diagnostic and treatment equipment and abundant teaching resources of the Department of Colorectal Surgery II, SICSTEC provides surgeons with the best training experience.

 In recent years, the Department of Colorectal Surgery II has not only attracted visits and exchanges from authoritative surgical scholars worldwide, including those from France, Italy, Russia, Australia, Brazil, Singapore, South Korea, and other countries, but also the colorectal cancer team of FUSCC has been invited to the international stage multiple times. Through continuous dialogue with high-level experts globally, they have not only learned advanced experiences but also showcased the wisdom and elegance of Chinese colorectal cancer scholars to the world.