Frontiers in Oncology (Apr 2023)

Postoperative circulating tumor DNA testing based on tumor naïve strategy after liver metastasis surgery in colorectal cancer patients

  • Huiqin Jiang,
  • Fei Huang,
  • Yihui Yang,
  • Xinning Chen,
  • Minna Shen,
  • Chunyan Zhang,
  • Chunyan Zhang,
  • Baishen Pan,
  • Baishen Pan,
  • Beili Wang,
  • Beili Wang,
  • Beili Wang,
  • Wei Guo,
  • Wei Guo,
  • Wei Guo,
  • Wei Guo,
  • Wei Guo

DOI
https://doi.org/10.3389/fonc.2023.1153685
Journal volume & issue
Vol. 13

Abstract

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ObjectiveThere is still a lack of highly sensitive methods for monitoring recurrence of colorectal cancer patients after liver metastasis surgery. The aim of this study was to evaluate the prognostic value of tumor-naive ctDNA detection after resection of colorectal liver metastases (CRLM).MethodsPatients with resectable CRLM were prospectively enrolled. Based on the tumor-naive strategy, NGS panels containing 15 colorectal cancer hotspot mutated genes were used to detect ctDNA 3-6 weeks after surgery.ResultsA total of 67 patients were included in the study, and the positive rate of postoperative ctDNA was 77.6% (52/67). Patients with positive ctDNA had a significantly higher risk of recurrence after surgery (HR 3.596, 95% CI 1.479 to 8.744, P = 0.005), and a higher proportion relapsed within 3 months after surgery (46.7% vs 3.8%). The C-index of postoperative ctDNA in predicting recurrence was higher than that of CRS and postoperative CEA. The nomogram combining CRS and postoperative ctDNA can improve the accuracy of recurrence prediction.ConclusionTumor-naive ctDNA detection can detect molecular residual lesions in patients with colorectal cancer after liver metastasis, and its prognostic value is superior to conventional clinical factors.

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