On March 30, 2025, the Chinese Society of Clinical Oncology (CSCO) held its third re-election meeting for the Committee on Minimally Invasive Oncology Surgery, along with the Forum on Discipline Development in Minimally Invasive Surgical Oncology, in Shanghai. During the meeting, Oncology Frontier invited Professor Qingguo Li from Fudan University Shanghai Cancer Center to share his insights and experiences on the progress and innovation in minimally invasive cancer surgery.Oncology Frontier: At this year’s meeting, you gave an excellent presentation on the development of an expert consensus for the prevention and management of Low Anterior Resection Syndrome (LARS) in rectal cancer. Why does this condition warrant special attention?
Professor Qingguo Li: At this meeting, we proposed the initial framework for developing a clinical consensus on LARS under the CSCO Committee for Minimally Invasive Oncology Surgery and had in-depth discussions with our peers. When treating cancer patients, our responsibility goes beyond achieving good clinical outcomes—we must also focus on improving quality of life.
LARS is a challenge colorectal surgeons cannot ignore. With advancements in surgical techniques, many patients with ultra-low rectal cancer now have the possibility of anus-preserving surgery. However, these patients often face postoperative issues such as altered bowel habits, increased frequency of defecation, or difficulty with evacuation. Proactive interventions are essential. Without timely and proper management, these complications can significantly affect patients’ quality of life.
Despite its prevalence, there are few international or domestic expert consensus guidelines on LARS. Most available data are from small retrospective or experience-based studies. Establishing a standardized consensus for the diagnosis and management of LARS is urgently needed—it will help guide clinical practice and, more importantly, contribute to improving the long-term quality of life for patients with low rectal cancer.
Oncology Frontier: Our consensus emphasizes postoperative quality of life for rectal cancer patients. In light of the rapid advancement in minimally invasive technologies, how do you think surgeons should balance survival outcomes with quality of life?
Professor Qingguo Li: Minimally invasive techniques have matured considerably. In the past, our understanding of “minimally invasive” was limited to smaller abdominal incisions. Today, advances in minimally invasive surgery have not only improved surgical outcomes but also significantly enhanced patients’ quality of life.
Take rectal cancer as an example—using minimally invasive approaches allows for more precise dissection, enabling anus preservation even in patients with very low tumors. At our center, we have been actively promoting and training others in minimally invasive techniques. Many colleagues who visit remark that we adopted these techniques early and follow standardized protocols, especially with regard to preserving nerve function.
In fact, many of our rectal cancer patients have their urinary catheters removed just three days after surgery. Thanks to the magnification provided by laparoscopic equipment, we can better protect the pelvic and abdominal nerve plexuses. This results in early recovery of bladder function and better preservation of long-term genitourinary and sexual function.
Therefore, the current focus of minimally invasive development is shifting toward enhancing long-term quality of life for patients—not just short-term recovery or cosmetic outcomes.
Professor Qingguo Li
Fudan University Shanghai Cancer Center
- Chief Surgeon, Associate Professor, Master’s Supervisor
- Lead Clinician and Group Head, Division of Colorectal Surgery II
- Youth Council Member, Shanghai Anti-Cancer Association
- Member, Colorectal and Anal Surgery Group, General Surgery Branch, Shanghai Medical Association
- Secretary-General and Chair of Youth Committee, Laparoscopic Gastrointestinal Oncology Committee, Shanghai Anti-Cancer Association
- Youth Member, Colorectal Oncology Committee, Chinese Medical Doctor Association
- Secretary-General and Committee Member, Multidisciplinary Colorectal Cancer Treatment Committee, Proctology Branch, Chinese Medical Doctor Association
- Secretary, Rectal Cancer Prevention and Treatment Committee, General Surgery Branch, Chinese Society of Integrative Medicine
- Member, Anus Preservation Group, Low Rectal Cancer Committee, Colorectal Oncology Branch, Chinese Medical Doctor Association
- Member, Surgical Oncology Supportive Therapy Committee, Chinese Anti-Cancer Association
- Member, Oncology Committee, Chinese Research Hospital Association
- Member, Colorectal Surgery Group, Young Talent Forum of Chinese Society of Digestive Surgery
- Member, Colorectal Cancer Committee, China Primary Health Care Foundation
- Section Editor for Colorectal Cancer, Annals of Translational Medicine
Academic Achievements: Professor Li has led two national-level research projects and three at the provincial or ministerial level. He has published over 50 academic papers as first or corresponding author.
Honors:
- Second Prize, Shanghai Anti-Cancer Science and Technology Award (as project lead)
- Second Prize, Chinese Anti-Cancer Association Science and Technology Award (as core contributor)
- Third Prize, Chinese Medical Science and Technology Award
- Second Prize, Shanghai Medical Science and Technology Award
Clinical Expertise: Professor Li specializes in comprehensive treatment centered around colorectal cancer surgery, with a particular focus on minimally invasive procedures and anus-preserving surgeries for low rectal cancer.
