The field of colorectal surgery is pivotal for the management of colorectal cancer and complex benign disorders, yet postoperative prognoses remain inconsistent, challenging both clinicians and patients. Recent advances suggest that a range of biomarkers—including molecular, proteomic, metabolomic, microbiome, and digital phenotypes—hold the potential to identify patients at heightened risk for complications or disease recurrence. Notable studies have revealed associations between specific biomarkers, such as circulating tumor DNA and inflammatory markers, with postoperative events and long-term survival. However, despite the proliferation of promising candidates, major gaps persist: few biomarkers are rigorously validated, standardized thresholds are lacking, and real-world integration into clinical workflows is minimal. The ongoing debate centers on how best to translate high-impact biomarker discoveries into actionable tools that improve patient outcomes, particularly across diverse populations and care settings.

This Research Topic aims to drive innovation in the discovery, validation, and clinical implementation of biomarkers that can robustly predict postoperative outcomes in colorectal surgery. Key objectives are to bridge the translational divide by supporting multidisciplinary research that advances biomarker-guided risk assessment, supports precision perioperative care, and catalyzes progress from mechanistic insights to real-world deployment. We especially seek contributions that address reproducibility, equity, and clinical utility—including dynamic risk modeling, cost-effectiveness, and the personalization of follow-up and intervention strategies. Specific research questions may include identifying novel molecular signatures for postoperative prognosis, developing multivariable predictive models, and examining biomarker performance in different surgical and patient subpopulations.

The scope of this Research Topic encompasses the continuum from discovery science to implementation in routine care, without addressing biomarkers exclusive to non-surgical treatment settings. Manuscripts should be grounded in the context of colorectal surgery, with clear clinical relevance and rigorous methodology. We welcome articles addressing, but not limited to, the following themes:

• Discovery and validation of molecular, genomic, proteomic, and metabolomic biomarkers for postoperative outcomes;
• Inflammatory and microbiome-based biomarkers for predicting complications such as anastomotic leak and infection;
• Circulating tumor DNA (ctDNA) and minimal residual disease assessments for recurrence risk;
• Integration of biomarkers with clinical, imaging, and surgical data into predictive models, including machine learning approaches;
• Dynamic, perioperative biomarkers and trajectory analysis;
• Biomarker-guided strategies for ERAS pathways, surveillance, and intervention triggers;
• Evaluation of biomarker generalizability and equity across demographic groups, tumor subtypes, and health systems;
• Implementation science: assay standardization, regulatory considerations, and harmonization of reporting;
• Cost-effectiveness, decision-curve analyses, and health-economic impact.

We welcome original research, systematic reviews, meta-analyses, methodological/statistical papers, translational studies, brief reports, protocols, and consensus statements.

Are you interested in contributing a manuscript to this Research Topic?

The Role of Biomarkers in Predicting Postoperative Prognosis in Colorectal Surgery