Susana Ourô , general and colorectal surgeon at Hospital da Luz and Hospital Beatriz Ângelo, concluded last January 21 her doctorate degree in Medicine, speciality of Clinical Research, at the Faculty of Medical Sciences (Nova Medical School), Universidade Nova de Lisboa. For her thesis, which obtained unanimously the maximum ranking, distinction and praise, the physician did a research on the biological and surgical factors that are decisive in the treatment of rectal cancer. In the abstract introducing her thesis, Susana Ourô explains: “Rectal cancer is a very complex disease that has been rising in younger ages , with a huge impact in the quality of life. It is an extremely heterogeneous pathology in terms of development, depending on different factors which determine not only its course, but also the response to the therapeutics”. “In recent decades, significant progress has been made in the approach to rectal cancer, thanks to a better understanding of the disease’s physiopathology, leading to the emergence of new options of treatment.” “The therapeutic concept also changed, from a perspective exclusively focused on the oncologic outcomes, to a model with concerns related with the functional results and quality of life.” Therefore, the question on the basis of this thesis was : “Is it possible to find biological and surgical determinants in the treatment of rectal cancer, in order to reduce morbidity associated with the therapeutics, but still obtaining the desired results?”. The investigation resulted in the publication of seven original scientific articles. Among the main conclusions of the thesis – entitled “Biological and Surgical Determinants in the treatment of Rectal Cancer” –, Susana Ourô highlights that: There are several biological factors that influence the therapeutic results of rectal cancer, but also an undeniable impact of the selected surgical option. Our goal being to obtain better results with the lower morbidity, it is necessary to identify the biological and surgical determinants of optimal treatment; This work allowed to confirm the role of microRNAs (genes) in the process of development of a rectal tumour and, in particular, the influence of the microRNA-21 in the response to chemoradiotherapy applied before surgery; Equally relevant is the surgical option in the different clinical contexts: surgical interventions should be individualized through the selective use of transanal total mesorectal excision for distal tumours, and post-chemoradiotherapy local excision for high-risk patients with good response. It is also imperative to better select patients for derivative ileostomy and control the modifiable risk factors, in order to reduce morbidity associated with protective stoma. In the photo above , the new doctor and the jury: Paulo Costa, Rui Maio, Susana Ourô, José Fragata, Marília Cravo, João Pimentel and Jorge Paulino.
