Circulating tumor DNA as a prognostic indicator of colorectal cancer recurrence-a systematic review and meta-analysis

Int J Colorectal Dis. 2022 May;37(5):1021-1027. doi: 10.1007/s00384-022-04144-4. Epub 2022 Apr 6.

Abstract

Purpose: Colorectal cancer (CRC) is one of the leading causes of cancer-related death worldwide. After resection, patients need extensive follow-up to detect asymptomatic recurrences as early as possible to obtain optimal treatment. This study evaluated the prognostic value of circulating tumor DNA (ctDNA) for CRC recurrence.

Methods: Two investigators independently conducted a systematic literature search of peer-reviewed studies that investigated the prognostic value of ctDNA in CRC. Fixed effects or random effects models were applied for all analyses based on the assessment of heterogeneity.

Results: A total of 189 studies were initially retrieved from all databases; ultimately, eight studies with 879 CRC patients were included in this analysis. The pooled median recurrence-free survival was 11.36 months for ctDNA-positive patients. Meta-analysis of hazard ratio (HR) suggested that postoperative ctDNA-positive patients were more likely to experience cancer recurrence than ctDNA-negative patients (pooled HR: 5.41; 95% confidence interval (CI): 2.37-8.45).

Conclusions: Successive monitoring of ctDNA status and follow-up with postoperative computed tomography (CT)/magnetic resonance imaging (MRI) are useful tools to detect early recurrence in postoperative ctDNA-positive patients.

Keywords: Colorectal cancer; Meta-analysis; Prognostic indicator; Recurrence; ctDNA.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Biomarkers, Tumor / genetics
  • Circulating Tumor DNA* / genetics
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / genetics
  • Colorectal Neoplasms* / surgery
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Prognosis
  • Prospective Studies
  • Recurrence

Substances

  • Biomarkers, Tumor
  • Circulating Tumor DNA