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; Baishen Pan; Beili Wang; Wei Guo

doi:10.3389/fonc.2023.1153685

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

Front Oncol. 2023 Apr 28:13:1153685. doi: 10.3389/fonc.2023.1153685. eCollection 2023.

Authors

Huiqin Jiang¹, Fei Huang¹, Yihui Yang¹, Xinning Chen¹, Minna Shen¹, Chunyan Zhang^{1

2}, Baishen Pan^{1

3}, Beili Wang^{1

2

3}, Wei Guo^{1

2

3

4

5}

Affiliations

¹ Department of Laboratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
² Department of Laboratory Medicine, Xiamen Branch, Zhongshan Hospital, Fudan University, Xiamen, China.
³ Department of Laboratory Medicine, Wusong Branch, Zhongshan Hospital, Fudan University, Shanghai, China.
⁴ Branch of National Clinical Research Center for Laboratory Medicine, Shanghai, China.
⁵ Cancer Center, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Objective: There 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).

Methods: Patients 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.

Results: A 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.

Conclusion: Tumor-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.

Keywords: circulating tumor DNA (ctDNA); colorectal cancer liver metastases (CRLM); minimal residual disease (MRD); next-generation sequencing – NGS; recurrence.

Grants and funding

This study was supported by Zhongshan Hospital (2018ZSLC05, 2020ZSLC54), the Constructing Project of Clinical Key Disciplines in Shanghai (shslczdzk03302), Science and Technology Commission of Shanghai Municipality (21YF1440200), the National Natural Science Foundation of China (81972000, 82172348, 81902139), and Shanghai Medical Key Specialty (ZK2019B28).