ctDNA May Predict Cancer Recurrence After Colorectal Surgery

M. Alexander Otto, PA, MMS

November 21, 2022

The study covered in this summary was published on medrxiv.org as a preprint and has not yet been peer reviewed.

Key Takeaway

  • Circulating tumor DNA (ctDNA) predicts recurrence after curative-intent surgery for colorectal cancer (CRC).

Why This Matters

  • The study shows that ctDNA may help identify patients who could benefit from adjuvant chemotherapy and heightened surveillance following CRC surgery.

Study Design

  • The team conducted a meta-analysis of postoperative ctDNA in patients with stage I–IV CRC following curative-intent resection.

  • Data for the analysis were pulled from 23 studies involving 3568 patients.

Key Results

  • Positive findings of ctDNA after surgery were significantly associated with low recurrence-free survival across all disease stages (hazard ratio [HR], 7.27).

  • Patients with stage I–III CRC who had a positive ctDNA finding were about eight times more likely to experience recurrence than those with a negative finding (HR, 8.14); patients with stage IV disease who had a positive finding were almost five times more likely to experience recurrence (HR, 4.83).

  • Among patients who received adjuvant chemotherapy after surgery, those who had a positive ctDNA result were about 10 times more likely to experience recurrence (HR, 10.59).

  • Tumor-informed ctDNA testing predicted higher rates of recurrence than tumor-agnostic testing.

Limitations

  • ctDNA testing is relatively new, and many studies had short follow-up.

Disclosures

  • Funding and authors' relevant financial relationships were not reported.

This is a summary of a preprint research study, "Circulating Tumor DNA as a MRD Assessment and Recurrence Risk in Patients Undergoing Curative Intent Resection With or Without Adjuvant Chemotherapy in Colorectal Cancer: A Meta-Analysis," led by Anusha Chidharla of the University of Kansas Cancer Center, Kansas City, provided to you by Medscape. The study has not been peer reviewed. The full text can be found at medrxiv.org.

M. Alexander Otto is a physician assistant with a master's degree in medical science and a journalism degree from Newhouse. He is an award-winning medical journalist who has worked for several major news outlets before joining Medscape and also an MIT Knight Science Journalism fellow. Email: aotto@mdedge.com.

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