Circulating tumour DNA and risk of recurrence in patients with asymptomatic versus symptomatic colorectal cancer.

Autor:	Øgaard N; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Jensen SØ; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Ørntoft MW; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Department of Surgery, Gødstrup Hospital, Herning, Denmark., Demuth C; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Rasmussen MH; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Henriksen TV; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Nors J; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Frydendahl A; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Lyskjær I; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Nesic M; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Therkildsen C; Gastro Unit, Surgical Section, Copenhagen University Hospital, Amager-Hvidovre, Denmark., Kleif J; Gastro Unit, Surgical Section, Copenhagen University Hospital, Amager-Hvidovre, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Gögenur M; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Jørgensen LN; Digestive Disease Centre, Bispebjerg Hospital, Copenhagen, Denmark., Vilandt J; Department of Surgery, Nordsjællands Hospital, Hillerød, Denmark., Seidelin JB; Department of Gastroenterology and Hepatology, Herlev Hospital, Herlev, Denmark., Gotschalck KA; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Surgery, Horsens Hospital, Horsens, Denmark., Jaensch C; Department of Surgery, Gødstrup Hospital, Herning, Denmark., Andersen B; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Public Health Programs and University Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, Denmark., Løve US; Department of Surgery, Viborg Hospital, Viborg, Denmark., Thorlacius-Ussing O; Clinical Cancer Research Center, Aalborg University, Aalborg, Denmark., Andersen PV; Department of Surgery, Odense University Hospital, Odense, Denmark., Kolbro T; Department of Surgery, Odense University Hospital, Svendborg, Denmark., Monti A; Department of Surgery, North Denmark Regional Hospital Hjørring, Hjørring, Denmark., Kildsig J; Department of Surgery, Copenhagen University Hospital, Herlev, Denmark., Bondeven P; Department of Surgery, Regional Hospital Randers, Randers, Denmark., Schlesinger NH; Digestive Disease Centre, Bispebjerg Hospital, Copenhagen, Denmark., Iversen LH; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.; Department of Surgery, Aarhus University Hospital, Aarhus, Denmark., Rasmussen M; Digestive Disease Centre, Bispebjerg Hospital, Copenhagen, Denmark., Gögenur I; Center for Surgical Science, Department of Surgery, Zealand University Hospital, Køge, Denmark., Bramsen JB; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark., Andersen CL; Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark. cla@clin.au.dk.; Institute of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark. cla@clin.au.dk.
Jazyk:	angličtina
Zdroj:	British journal of cancer [Br J Cancer] 2024 Nov; Vol. 131 (10), pp. 1707-1715. Date of Electronic Publication: 2024 Oct 10.
DOI:	10.1038/s41416-024-02867-5
Abstrakt:	Background: Multiple initiatives aim to develop circulating tumour DNA (ctDNA) tests for early cancer detection in asymptomatic individuals. The few studies describing ctDNA-testing in both asymptomatic and symptomatic patients report lower ctDNA detection in the asymptomatic patients. Here, we explore if asymptomatic patients differ from symptomatic patients e.g. by including a 'low-ctDNA-shedding' and 'less-aggressive' subgroup. Methods: ctDNA assessment was performed in two independent cohorts of consecutively recruited patients with asymptomatic colorectal cancer (CRC) (Cohort#1: n = 215, Cohort#2: n = 368) and symptomatic CRC (Cohort#1: n = 117, Cohort#2: n = 722). Results: After adjusting for tumour stage and size, the odds of ctDNA detection was significantly lower in asymptomatic patients compared to symptomatic patients (Cohort#1: OR: 0.4, 95%CI: 0.2-0.8, Cohort#2: OR: 0.7, 95%CI: 0.5-0.9). Further, the recurrence risk was lower in asymptomatic patients (Cohort#1: sHR: 0.6, 95%CI: 0.3-1.2, Cohort#2: sHR: 0.6, 95%CI: 0.4-1.0). Notably, ctDNA-negative asymptomatic patients had the lowest recurrence risk compared to the symptomatic patients (Cohort#1: sHR: 0.2, 95%CI: 0.1-0.6, Cohort#2: sHR: 0.3, 95%CI: 0.2-0.6). Conclusions: Our study suggests that asymptomatic patients are enriched for a 'low-ctDNA-shedding-low-recurrence-risk' subgroup. Such insights are needed to guide ctDNA-based early-detection initiatives and should prompt discussions about de-escalation of therapy and follow-up for ctDNA-negative asymptomatic CRC patients. Competing Interests: Competing interests The authors declare no competing interests. Ethics approval and consent to participate All participants provided informed consent and the study was approved by the Danish Committees on Health Research Ethics (j. no 1-10-72-223-14, H-4-2013-050, and 1-10-72-3-18) and reported according to STROBE guidelines [36]. (© 2024. The Author(s).)
Databáze:	MEDLINE
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