[Surgery and molecular biology: new insight or stray path?]

Surgery has the optimal possibility for theoretical-clinical transfer of molecular biological knowledge. On the basis of the existing research emphasis on clinical molecular biology at the Department of Surgery, University of Heidelberg, this is shown by the example of colorectal cancer: Establishment of a large clinical register for hereditary colorect cancer, use of molecular biological methods to improve phenotype/genotype correlations, definition of risk groups, decision on surgical therapeutical concepts for hereditary cancers and considerations on the creation of problem-orientated centers for hereditary cancer. A further example for the application of molecular methods is the detection of minimal residual disease or tumor cells in the different compartments (blood, lymph nodes, bone marrow and peritoneum) in order to achieve a better risk evaluation exceeding the standard pathohistological stage definition. The goal is an individualized or more focused therapy for each patient. Transfer of research from the basic sciences into the clinical setting, integrated into the daily clinical work, is possible in a so-called tandem model.