Prognostic Value of Postoperative Circulating Tumor DNA in Patients With Early- and Intermediate-Stage Hepatocellular Carcinoma

Yao, Ke; Fan, Qingyu; Yuan, Mingming; Wang, Dong; Liang, Xiao; Long, Guo; Chen, Rongrong; Fang, Tongdi; Li, Zengbo; Zhou, Ledu

doi:10.3389/fonc.2022.834992

Cited by 11 publications

(9 citation statements)

References 38 publications

(39 reference statements)

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“…des-γ-carboxy-prothrombin (DCP) was recently reported to be superior to AFP in detecting HCC recurrence ( 22 , 23 ). Furthermore, biomarkers such as circulating tumor DNA assays and circulating tumor cells have also been noted in the improvement of AFP prediction performance ( 24 ). However, research concerning biomarkers or combinations of biomarkers that are highly accurate and easy to detect is ongoing.…”

Section: Discussionmentioning

confidence: 99%

Effect of anatomical liver resection on early postoperative recurrence in patients with hepatocellular carcinoma assessed based on a nomogram: a single-center study in China

Shi,

Wang,

Zeng

et al. 2024

Front. Oncol.

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IntroductionWe aimed to investigate risk factors for early postoperative recurrence in patients with hepatocellular carcinoma (HCC) and determine the effect of surgical methods on early recurrence to facilitate predicting the risk of early postoperative recurrence in such patients and the selection of appropriate treatment methods.MethodsWe retrospectively analyzed clinical data concerning 428 patients with HCC who had undergone radical surgery at Mianyang Central Hospital between January 2015 and August 2022. Relevant routine preoperative auxiliary examinations and regular postoperative telephone or outpatient follow-ups were performed to identify early postoperative recurrence. Risk factors were screened, and predictive models were constructed, including patients’ preoperative ancillary tests, intra- and postoperative complications, and pathology tests in relation to early recurrence. The risk of recurrence was estimated for each patient based on a prediction model, and patients were categorized into low- and high-risk recurrence groups. The effect of anatomical liver resection (AR) on early postoperative recurrence in patients with HCC in the two groups was assessed using survival analysis.ResultsIn total, 353 study patients were included. Multifactorial logistic regression analysis findings suggested that tumor diameter (≥5/<5 cm, odds ratio [OR] 2.357, 95% confidence interval [CI] 1.368–4.059; P = 0.002), alpha fetoprotein (≥400/<400 ng/L, OR 2.525, 95% CI 1.334–4.780; P = 0.004), tumor number (≥2/<2, OR 2.213, 95% CI 1.147–4.270; P = 0.018), microvascular invasion (positive/negative, OR 3.230, 95% CI 1.880–5.551; P < 0.001), vascular invasion (positive/negative, OR 4.472, 95% CI 1.395–14.332; P = 0.012), and alkaline phosphatase level (>125/≤125 U/L, OR 2.202, 95% CI 1.162–4.173; P = 0.016) were risk factors for early recurrence following radical HCC surgery. Model validation and evaluation showed that the area under the curve was 0.813. Hosmer-Lemeshow test results (X2 = 1.225, P = 0.996 > 0.05), results from bootstrap self-replicated sampling of 1,000 samples, and decision curve analysis showed that the model also discriminated well, with potentially good clinical utility. Using this model, patients were stratified into low- and high-risk recurrence groups. One-year disease-free survival was compared between the two groups with different surgical approaches. Both groups benefited from AR in terms of prevention of early postoperative recurrence, with AR benefits being more pronounced and intraoperative bleeding less likely in the high-risk recurrence group.DiscussionWith appropriate surgical techniques and with tumors being realistically amenable to R0 resection, AR is a potentially useful surgical procedure for preventing early recurrence after radical surgery in patients with HCC.

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Section: Discussionmentioning

confidence: 99%

Effect of anatomical liver resection on early postoperative recurrence in patients with hepatocellular carcinoma assessed based on a nomogram: a single-center study in China

Shi,

Wang,

Zeng

et al. 2024

Front. Oncol.

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“…A large proportion of the patients with early and intermediate stage liver cancer after surgery will have recurrence. In a recent study, peripheral blood samples were collected from all patients after surgery and analyzed by next-generation sequencing based on hybrid capture ( Ye et al, 2022 ). The recurrence rates of ctDNA positive group and ctDNA negative group were 60.9% and 27.8%, respectively.…”

Section: Application Of Ctdna For Mrd Detectionmentioning

confidence: 99%

Minimal residual disease (MRD) detection in solid tumors using circulating tumor DNA: a systematic review

Zhu,

Xu,

Yang

et al. 2023

Front. Genet.

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Minimal residual disease (MRD) refers to a very small number of residual tumor cells in the body during or after treatment, representing the persistence of the tumor and the possibility of clinical progress. Circulating tumor DNA (ctDNA) is a DNA fragment actively secreted by tumor cells or released into the circulatory system during the process of apoptosis or necrosis of tumor cells, which emerging as a non-invasive biomarker to dynamically monitor the therapeutic effect and prediction of recurrence. The feasibility of ctDNA as MRD detection and the revolution in ctDNA-based liquid biopsies provides a potential method for cancer monitoring. In this review, we summarized the main methods of ctDNA detection (PCR-based Sequencing and Next-Generation Sequencing) and their advantages and disadvantages. Additionally, we reviewed the significance of ctDNA analysis to guide the adjuvant therapy and predict the relapse of lung, breast and colon cancer et al. Finally, there are still many challenges of MRD detection, such as lack of standardization, false-negatives or false-positives results make misleading, and the requirement of validation using large independent cohorts to improve clinical outcomes.

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“… 40 Furthermore, detection of circulating tumor DNA, otherwise called liquid biopsy, has also been postulated to increase the predictive performance of AFP. 41 Currently, there is no “best” biomarker combination to detect early HCC recurrence with high accuracy. Novel biomarkers are, however, critically important in specific patient subgroups, such as those individuals who are AFP-negative.…”

Section: Detection Of Recurrent Diseasementioning

confidence: 99%

Recurrent Hepatocellular Carcinoma: Patterns, Detection, Staging and Treatment

Papaconstantinou¹,

Tsilimigras²,

Pawlik³

2022

JHC

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Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide with the incidence of recurrence being as high as 88% even among patients who have undergone curative-intent treatment. Despite improvements in overall survival, recurrence remains a challenge necessitating accurate reappraisal of patient and disease status. To that end, accurate staging of recurrent HCC is a necessity to provide better care for these patients. Risk factors for poor survival after HCC recurrence have been identified and include characteristics of the primary disease, such as tumor multifocality, large size (≥5 cm), macroscopic vascular or microscopic lymphovascular invasion, preoperative a-fetoprotein (AFP) levels, R0 resection, and the presence of impaired liver function. Close surveillance with imaging is warranted following curative-intent therapy, with magnetic resonance imaging (MRI) being the preferred approach to identify small, early recurrent HCCs. Treatment decisions at the time of recurrence involve ruling out extrahepatic disease and identifying candidates for potentially curative-intent repeat treatment options. Patients with recurrent disease are, however, very diverse in terms of tumor morphology and biologic behavior, as well as residual hepatic functional reserve. Patients with preserved liver function may benefit from repeat liver resection or ablation. Patients with recurrence within the Milan criteria may even be candidates for salvage liver transplantation, while multimodality treatment with combination of liver-directed therapies appears to enhance oncologic outcomes for individuals with advanced recurrent disease. A “one-size-fits-all” approach in staging recurrent HCC does not exist. Rather, individualized and evidence-based decision-making is necessary in order to optimize outcomes for patients with recurrent HCC.

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Prognostic Value of Postoperative Circulating Tumor DNA in Patients With Early- and Intermediate-Stage Hepatocellular Carcinoma

Cited by 11 publications

References 38 publications

Effect of anatomical liver resection on early postoperative recurrence in patients with hepatocellular carcinoma assessed based on a nomogram: a single-center study in China

Effect of anatomical liver resection on early postoperative recurrence in patients with hepatocellular carcinoma assessed based on a nomogram: a single-center study in China

Minimal residual disease (MRD) detection in solid tumors using circulating tumor DNA: a systematic review

Recurrent Hepatocellular Carcinoma: Patterns, Detection, Staging and Treatment

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