Clinical department

The department of Colorectal Surgery has been established as an independent department since 2005, which used to be one division of the Department of Abdominal Surgery. Our primary clinical and research interests involve cancers of the colon, rectum, and anus, with particular interest in sphincter-preserving surgery for rectal cancer and multidisciplinary treatment of colorectal cancer.
Our department is the largest separated department of colorectal surgery in China, with a total of 60 beds specialized for surgical treatment of colorectal cancer. In the department, there are two professors, five associated professors, four attending surgeons and three residents. The chief of our department, Professor Sanjun Cai, leads the colorectal multidisciplinary group and colorectal cancer center of Fudan University. He is a skilled-surgeon on gastrointestinal oncology, malignant melanoma and soft tissue sarcoma, especially in colorectal cancer.
We perform over 1000 colorectal cancer surgeries every year, in which half of them are rectal cancers. As a leading institution in colorectal cancer treatment, hundreds of patients with recurrent disease were referred to our department each year. We do 50-80 operations for recurrent or metastatic lesions every year. In 2008, we studied 844 stage I-III rectal cancer patients treated with curative anterior resection for 20 years’ period in our hospital. The 5-year overall survival rate was 77.6% for all patients, and 5-year OS was 94.3%, 85.5%, 62.9% for stage I, II and III disease, respectively. The overall local recurrence rate was 7.94%.
Our department has plenty of experience of treating early stage rectal cancer with local excision for over 20 years. In 2009, using our colorectal cancer database, we studied the treatment outcomes difference between local resection and standard resection. The results were also discussed in NCCN guideline seminar in China. Meanwhile, our department is one of the earliest departments who started to use TEM (transanal endoscopic microdissection) technique to treat early rectal cancer, rectal carcinoid and benign rectal adenomas. We performed nearly 50 TEM surgeries each year. Microinvasive surgery of early colorectal cancer with laparoscopy and hand-assisted laparoscopy has also been started in recent years.

In 2006, the colorectal cancer multidisciplinary therapy team (MDT) was established, and Professor Sanjun Cai is the principle investigator of colorectal cancer MDT team. Our MDT team includes surgeons, radiological oncologists, medical oncologists, diagnostic radiologists and pathologists etc. Standardized preoperative chemo-radiotherapy for locally advanced rectal cancer has been performed in our team since then. After discussion and approval of MDT team members, we held several multicenter phase III clinical trials, such as preoperative chemoradiotherapy for locally advanced rectal cancer, palliative chemoradiotherapy for stage IV rectal cancer and liver resection for synchronous or metachronous liver metastases, etc.
As we have treated a large sum of patients with rectal cancer, who underwent abdomino-perineal resection in our department. We organized a patient-based club to help the stoma patients by holding lectures, training program and personal contacts. Our club is quickly expanding and now has over 200 members.
We carried out a lot of biological research work in early diagnosis, prognosis prediction of colorectal cancer. We also did a lot of studies in hereditary colorectal cancer. Our department was the first one to report HNPCC in China in 1980s. Many patients come to our hospital for genetic counseling. We carried out genome-wide gene expression profiling in fresh tissue and DASL in degraded tissue for locally advanced colorectal cancer. Some promising genes were found in prognosis prediction. We hope our research work in colorectal cancer can be utilized in clinical works and help all the patients.