Welcome to our website!
As clinician-scientists at the Department of Surgery at TUM University Hospital Munich, Technical University of Munich, we conduct basic and clinical research on clinically relevant aspects of the surgical treatment of esophageal and gastric cancer.
The main goals of our research are:
- Understanding the molecular and cellular mechanisms of gastrointestinal wound healing with focus particularly on anastomotic healing* to improve patient outcomes after curative cancer surgery of the upper gastrointestinal tract.
Anastomotic healing is a highly complex biological process. Not only must two different organs (e.g., the esophagus and the stomach) form a long-lasting functional connection involving different epithelial subtypes (such as the squamous epithelium of the esophagus and the gastric mucosa), but the distinct layers of the gastrointestinal tract (mucosa, muscularis, and serosa/adventitia), which are embryologically derived from different germ layers, must also reconnect.
Furthermore, the healing process takes place within the pleural or peritoneal cavity, parts of the coelomic cavities, which host rarely studied cell types, including mesothelial cells and specialized peritoneal immune cells such as large peritoneal macrophages and innate B cells.
One of our main focuses is to elucidate the role of mesothelial cells the highly plastic epithelial cells of the coelomic cavities, during anastomotic healing, as well as their interaction with peritoneal and pleural macrophages during the postoperative healing process.
*Anastomotic healing refers to the healing of suture lines between internal organs (e.g., between the esophagus and the stomach, or the stomach and the small intestine), which are crucial for reconstructing gastrointestinal continuity after upper gastrointestinal cancer surgery.
- Analyzing real-world clinical and population-based clinical data with a focus on postoperative outcomes to improve perioperative patient care.
The risk of wound healing and functional complications following upper gastrointestinal surgery remains a partially unresolved issue, even after curative treatment, similar to adverse effects observed during medical therapy. By analyzing and critically interpreting perioperative, intraoperative, and postoperative clinical data, our aim is to generate clinically relevant insights to improve patient outcomes.
Our long-term goals are to:
(I) define relevant and applicable risk management tools,
(II) identify patients at risk for postoperative complications in order to implement early prevention and treatment strategies to reduce failure-to-rescue rates, and
(III) prepare the foundation for randomized clinical trials to generate evidence-based recommendations for best perioperative practices.
- Understanding the response to perioperative medical treatment of upper gastrointestinal cancers, particularly adenocarcinoma of the stomach and the gastroesophageal junction to perioperative medical treatment within their organ and metabolic context, in order to improve therapeutic efficacy.
The tumor microenvironment includes not only the immune compartment but also a mesenchymal milieu (stroma), which consists, among others, of cancer-associated fibroblasts, adipocytes, mesenchymal precursor cells, and the extracellular matrix. As surgeons, we are exposed not only to the primary tumor but also to this surrounding microenvironment during surgical procedures.
Using 2D and 3D in vitro models, including patient-derived organoid cultures, our goal is to better understand treatment responses to perioperative chemotherapy in the context of both the mesenchymal tumor environment and its associated metabolic conditions.
Contact:
Dr. med. Marie-Christin Weber | marie-christin.weber@tum.de | Publications
Prof. Dr. med. Daniel Reim | daniel.reim@tum.de | Publications
Dr. med. Jara Tigges | jara.tigges@tum.de
Prof. Dr. med. Marcus Feith | marcus.feith@tum.de