Circulating Tumor DNA as a Biomarker for Recurrence After Curative Resection of Colorectal Cancer Liver Metastases: A Systematic Review and Meta-Analysis

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2026-06-01 Epub Date: 2026-01-29 DOI:10.1016/j.clcc.2026.01.006

Atta Ullah Khan , Abdul Ahad Mehboob , Asraa Abdulsahib Yousif , Awais Ali , Mustafa Jawad Kadham

{"title":"Circulating Tumor DNA as a Biomarker for Recurrence After Curative Resection of Colorectal Cancer Liver Metastases: A Systematic Review and Meta-Analysis","authors":"Atta Ullah Khan , Abdul Ahad Mehboob , Asraa Abdulsahib Yousif , Awais Ali , Mustafa Jawad Kadham","doi":"10.1016/j.clcc.2026.01.006","DOIUrl":null,"url":null,"abstract":"<div><div>Colorectal liver metastases (CRLM) remain a leading cause of cancer-related mortality, with recurrence rates of 50 to 70% following curative-intent hepatic resection. Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for minimal residual disease (MRD) detection, yet its prognostic value in resected CRLM has not been systematically quantified. A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420251177140). MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Scopus were searched through October 2025. Studies evaluating ctDNA as a prognostic biomarker in adults with resected CRLM were included. Hazard ratios (HRs) for recurrence-free survival (RFS) and overall survival (OS) were pooled using random-effects models. Evidence certainty was assessed using GRADE methodology. Ten studies (1034 patients) were included. Postoperative ctDNA positivity was significantly associated with inferior RFS in the MRD window (HR 3.28, 995% CI, 2.58-4.17; I² = 10%) and after adjuvant chemotherapy (HR 8.69, 995% CI, 5.43-13.90; I² = 0%). ctDNA positivity was also associated with reduced OS (HR 7.11, 995% CI, 3.87-13.09). ctDNA detection preceded radiological recurrence by 3.5 to 6.1 months. Preoperative ctDNA was not a statistically significant predictor. ctDNA is a promising prognostic biomarker in resected CRLM, strongly associated with recurrence and mortality. However, prospective randomized trials are needed before routine clinical implementation.</div></div>","PeriodicalId":10373,"journal":{"name":"Clinical colorectal cancer","volume":"25 2","pages":"Pages 181-190.e1"},"PeriodicalIF":2.7000,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical colorectal cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S153300282600006X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/29 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Colorectal liver metastases (CRLM) remain a leading cause of cancer-related mortality, with recurrence rates of 50 to 70% following curative-intent hepatic resection. Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for minimal residual disease (MRD) detection, yet its prognostic value in resected CRLM has not been systematically quantified. A systematic review and meta-analysis was conducted following PRISMA 2020 guidelines (PROSPERO: CRD420251177140). MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Scopus were searched through October 2025. Studies evaluating ctDNA as a prognostic biomarker in adults with resected CRLM were included. Hazard ratios (HRs) for recurrence-free survival (RFS) and overall survival (OS) were pooled using random-effects models. Evidence certainty was assessed using GRADE methodology. Ten studies (1034 patients) were included. Postoperative ctDNA positivity was significantly associated with inferior RFS in the MRD window (HR 3.28, 995% CI, 2.58-4.17; I² = 10%) and after adjuvant chemotherapy (HR 8.69, 995% CI, 5.43-13.90; I² = 0%). ctDNA positivity was also associated with reduced OS (HR 7.11, 995% CI, 3.87-13.09). ctDNA detection preceded radiological recurrence by 3.5 to 6.1 months. Preoperative ctDNA was not a statistically significant predictor. ctDNA is a promising prognostic biomarker in resected CRLM, strongly associated with recurrence and mortality. However, prospective randomized trials are needed before routine clinical implementation.

查看原文本刊更多论文

循环肿瘤DNA作为结直肠癌肝转移治疗切除后复发的生物标志物：系统回顾和荟萃分析

结直肠癌肝转移（CRLM）仍然是癌症相关死亡的主要原因，在治疗目的肝切除术后复发率为50%至70%。循环肿瘤DNA （ctDNA）已成为微小残留疾病（MRD）检测的有希望的生物标志物，但其在切除的CRLM中的预后价值尚未被系统量化。根据PRISMA 2020指南（PROSPERO: CRD420251177140）进行了系统评价和荟萃分析。MEDLINE、Embase、Web of Science、Cochrane CENTRAL和Scopus的检索截止到2025年10月。评估ctDNA作为成年CRLM切除患者预后生物标志物的研究被纳入。使用随机效应模型对无复发生存期（RFS）和总生存期（OS）的风险比（hr）进行汇总。证据确定性采用GRADE方法评估。纳入10项研究（1034例患者）。术后ctDNA阳性与MRD窗口较差的RFS （HR 3.28, 995% CI, 2.58-4.17; I²= 10%）和辅助化疗后较差的RFS （HR 8.69, 995% CI, 5.43-13.90; I²= 0%）显著相关。ctDNA阳性也与OS降低相关（HR 7.11, 995% CI, 3.87-13.09）。ctDNA检测在放射复发前3.5 ~ 6.1个月。术前ctDNA不是统计学上显著的预测因子。ctDNA是一种很有希望的预后生物标志物，与复发和死亡率密切相关。然而，在常规临床应用之前，需要前瞻性随机试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.