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Meta-Analysis
. 2023 Feb 10;102(6):e32939.
doi: 10.1097/MD.0000000000032939.

CtDNA's prognostic value in patients with early-stage colorectal cancer after surgery: A meta-analysis and systematic review

Xiaoyuan Fan  1 , Jiakai Zhang  2 , Dewen Lu  1
Affiliations
Meta-Analysis

CtDNA's prognostic value in patients with early-stage colorectal cancer after surgery: A meta-analysis and systematic review

Xiaoyuan Fan et al. Medicine (Baltimore). .

Abstract

Background: Circulating tumor DNA (ctDNA) positivity has been shown to suggest the presence of minimally residual tumor cells in numerous investigations. We aimed to assess the prognostic value of ctDNA positivity for recurrence-free survival in patients with early-stage colorectal cancer after radical surgery and following adjuvant chemotherapy.

Methods: We systematically reviewed studies published in English until August 15, 2022, concerning ctDNA and tumor-node-metastasis I to III colorectal cancer after surgery, and quantified the correlation between ctDNA positivity and early-stage (tumor-node-metastasis stage I-III) colorectal cancer using meta-analysis methods.

Results: In total, the meta-analysis comprised 1713 patients from 6 studies. Patients with ctDNA-positive colorectal cancer after surgery had a significantly higher risk of recurrence than patients with ctDNA-negative colorectal cancer (hazard ratio 4.64, 95% confidence interval 2.17-9.92, z = 3.96; P < .001). After adjuvant chemotherapy, patients who were ctDNA-positive had a significantly higher risk of recurrence than those who were ctDNA-negative (hazard ratio 7.27, 95% confidence interval 4.50-11.75, z = 8.1; P < .001).

Conclusions: CtDNA positivity may potentially be a predictor for early-stage colorectal tumor recurrence following surgery and adjuvant chemotherapy.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
PRISMA flow diagram for study selection. PRISMA = Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Figure 2.
Figure 2.
Forest plots for univariate RFS in patients with early-stage colorectal cancer after surgery. RFS = recurrence-free survival.
Figure 3.
Figure 3.
Forest plots for multivariate RFS in patients with early-stage colorectal cancer after surgery. RFS = recurrence-free survival.
Figure 4.
Figure 4.
Forest plots for RFS in patients with early-stage colorectal cancer after adjuvant chemotherapy. RFS = recurrence-free survival.
See this image and copyright information in PMC

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