P4. Hepatic and Digestive Oncology

Coordinator: Bruno Sangro

Clinical and scientific relevance of the areas covered in the programme

Death by cancer currently takes the top positions in causes of mortality at the population level. Both colorectal and liver cancer are among the three most frequently found forms of cancer. Gastric, oesophageal or pancreatic cancer have lower prevalence, but as a whole, mortality through liver and gastrointestinal cancer must be considered the most frequent cause of death among the adult population. This must therefore be considered a major healthcare problem and boosting research plans connected with cancer comes forward as a priority issue.

Current situation of research in hepatic and gastrointestinal cancer

Research into cancer is one of the areas where most work is done and with greatest possibilities for development, which is why it is constantly evolving. Years ago, clinical research was considered to be restricted to the aspects connected with treatment of the neoplasic disease in an advanced state, while basic research was done on cell lines or experimental models. At the same time research on epidemiological aspects, the evaluation of the risk of developing a neoplasia, diagnosis technology or strategies for defining prognosis after potentially curative treatment such as surgical resection belonged to the specific field of different specialities (public health, radiology, pathological anatomy, surgery etc..). Today such a segregated approach is absolutely obsolete. The steps forward described below have transformed cancer research into an absolutely transversal field in which the bounds set by conventional healthcare specialities are no longer valid at all. The molecular epidemiology of colorectal cancer and the treatment of disseminated disease are good examples of this point. Hence, the application of findings on the genetic level in healthcare practice places molecular genetics in clinical research, while the search for tumour dissemination markers and new therapeutic targets to prevent metastases requires structuring the care for these patients in a close relationship with laboratory research.

Recent progress

Cooperation between the different fields of knowledge has significantly increased knowledge of hepatic and gastrointestinal cancer and marks out the points from which the research to be done should set out.

There are many markers of hereditary or acquired risk of developing cancer which enable identifying individuals at risk which stem from follow-up plans structured to detect the disease in initial stages of its development even though it is feasible to apply potentially curative treatment.

The stages defining the transition of preneoplasic lesion to cancer in situ and finally cancer established as oesophageal, colorectal and hepatic cancer have been characterised. The demarcation of the correlation between phenotypic pattern and molecular anomalies has been got under way.

Program Group Members

Main ResearcherConsortium InstitutionRegionsDetails
Jordi Bruix Hospital Clínico y Provincial Cataluña View Group

Luis Bujanda Fernández de Piérola

Asociación Instituto Biodonostia País Vasco View Group
Antoni Castells Hospital Clínico y Provincial Cataluña View Group
José Juan García Marín Universidad de Salamanca

Castilla y León

View Group
Pascual Parrilla Fundación para la Formacion e Investigacion Sanitarias de la Región de Murcia (FFIS) Murcia View Group
Francisco Javier Padillo (grupo vinculado) Hospital Universitario Virgen del Rocío Andalucía View Group
Marçal Pastor- Anglada Universidad de Barcelona Cataluña View Group

Bruno Sangro (Coordinador de Programa)

Clínica Universitaria de Navarra Navarra View Group