Prognostic Value of Circulating Tumor DNA-Based Minimal Residual Disease for Recurrence-Free Survival in Resectable Gastric Cancer: A Systematic Review and Meta-Analysis with Serial Monitoring Analysis.
Abdul Ahad Mehboob, Abdul Ghani Iqbal, Tooba Shaukat Butt et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and meta-analysis evaluated the prognostic value of circulating tumor DNA (ctDNA)-based minimal residual disease (MRD) in 520 patients with resectable gastric cancer. The study found that postoperative ctDNA positivity was significantly associated with reduced recurrence-free survival (RFS: HR 12.26) and overall survival (OS: HR 8.57), indicating its potential as a biomarker in this population.
Key findings
- Postoperative ctDNA positivity was linked to a 12.26-fold increase in risk of recurrence-free survival.
- Overall survival was adversely affected with a hazard ratio of 8.57 for ctDNA positivity.
- Postoperative ctDNA detection had a stronger prognostic value (HR 10.00) compared to preoperative assessment (HR 2.17).
- Substantial heterogeneity was noted among studies, with I² values ranging from 65-72%.
Why it matters
Understanding the prognostic implications of ctDNA in resectable gastric cancer can help clinicians identify high-risk patients who may benefit from closer monitoring or additional therapeutic strategies, although its clinical utility is not yet established.
What to keep in mind
The analysis is limited by the small number of studies and substantial heterogeneity in ctDNA assay characteristics and postoperative sampling timing.