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Utility of Circulating Tumor DNA Assessment in Characterizing Recurrence Sites after Optimal Resection for Metastatic Colorectal Cancer.
- Source :
-
Journal of the American College of Surgeons [J Am Coll Surg] 2024 Jun 01; Vol. 238 (6), pp. 1013-1020. Date of Electronic Publication: 2024 Feb 01. - Publication Year :
- 2024
-
Abstract
- Background: Plasma circulating tumor DNA (ctDNA) is a promising biomarker for metastatic colorectal cancer (mCRC); however, its role in characterizing recurrence sites after mCRC resection remains poorly understood. This single-institution study investigated the timing of ctDNA detection and its levels in the context of recurrence at different sites after mCRC resection.<br />Study Design: Patients who underwent optimal resection of CRC metastases involving the peritoneum, distant lymph nodes, or liver, with serial postoperative tumor-informed ctDNA assessments (Signatera) were included. Recurrence sites, as defined by surveillance imaging or laparoscopy, were categorized as peritoneal-only and other distant sites (liver, lung, lymph nodes, or body wall).<br />Results: Among the 31 included patients, ctDNA was detected in all 26 (83.4%) patients with postoperative recurrence and was persistently undetectable in 5 patients who did not experience recurrence. At 3 months postsurgery, ctDNA was detected in 2 (25%) of 8 patients with peritoneal-only recurrence and 17 (94.4%) of 18 patients with distant recurrence (p < 0.001). Beyond 3 months, ctDNA was detected in the remaining 6 patients with peritoneal-only disease and 1 patient with distant disease. ctDNA detection preceded the clinical diagnosis of recurrence by a median of 9 weeks in both groups. At recurrence, peritoneal-only recurrent cases exhibited lower ctDNA levels (median 0.4 mean tumor molecules/mL, interquartile range 0.1 to 0.8) compared with distant recurrence (median 5.5 mean tumor molecules/mL, interquartile range 0.8 to 33.3, p = 0.004).<br />Conclusions: Peritoneal-only recurrence was associated with delayed ctDNA detection and low levels of ctDNA after optimal resection for mCRC. ctDNA testing may effectively characterize recurrence sites and may help guide subsequent treatments specific to the disease sites involved.<br /> (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Female
Male
Middle Aged
Aged
Adult
Peritoneal Neoplasms secondary
Peritoneal Neoplasms blood
Peritoneal Neoplasms genetics
Peritoneal Neoplasms diagnosis
Peritoneal Neoplasms surgery
Aged, 80 and over
Retrospective Studies
Liver Neoplasms secondary
Liver Neoplasms surgery
Liver Neoplasms blood
Liver Neoplasms genetics
Liver Neoplasms diagnosis
Circulating Tumor DNA blood
Circulating Tumor DNA genetics
Colorectal Neoplasms pathology
Colorectal Neoplasms blood
Colorectal Neoplasms surgery
Colorectal Neoplasms genetics
Neoplasm Recurrence, Local blood
Neoplasm Recurrence, Local diagnosis
Biomarkers, Tumor blood
Biomarkers, Tumor genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1190
- Volume :
- 238
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 38299640
- Full Text :
- https://doi.org/10.1097/XCS.0000000000001028