Objective To explore the clinical application value of circulating tumor DNA (ctDNA) in prognostic evaluation of esophageal malignancies. Methods Pubmed, Cochrane Library, Embase and Web of Science databases were used to search articles discussing the clinical application value of ctDNA in the prognosis assessment of esophageal malignancies from the establishment of the database to November 24, 2022. Two researchers independently searched the database, screened the literature, extracted and analyzed the data, analyzed the risk of bias in the included literature, extracted the risk ratio (hr) of disease-free survival (DFS) and overall survival (OS), and used Revman 5.3 for statistical analysis. Chi-square test was used to calculate the heterogeneity among the combined results. Results A total of 321 patients were included in this study, among which 8 studies were included in the PFS meta-analysis of ctDNA prediction of esophageal malignancies. he heterogeneity of progression-free survival (PFS) in patients with esophageal malignancies was low (I2=28%, P>0.05), so the fixed-effect model was used (HR=4.14, 95%CI :2.65~6.47, P<0.05). The results showed that ctDNA-positive patients were associated with poor PFS. In the meta-analysis of ctDNA’s prediction of overall survival (OS) in patients with esophageal malignancies, a total of 4 studies were included, with low heterogeneity(I2=15%, P>0.05). Using a fixed-effect model, CtDNA-positive patients had worse prognosis than ctDNA-negative patients with OS(HR=4.71, 95%CI: 2.78~7.97, P<0.05). Conclusions Tumor-associated ctDNA detection is expected to become an auxiliary prognostic measure for patients with esophageal malignancies.
Key words
esophageal malignancy /
ctDNA /
Meta-analysis
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Sung H, Ferlay J, Siegel R L, et al. Global cancer statistics 2020: GLOBOCAN Estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021,71(3):209-249.
[2] Schneider P M, Metzger R, Schaefer H, et al. Response evaluation by endoscopy, rebiopsy, and endoscopic ultrasound does not accurately predict histopathologic regression after neoadjuvant chemoradiation for esophageal cancer[J]. Ann Surg, 2008,248(6):902-908.
[3] Azad T D, Chaudhuri A A, Fang P, et al. Circulating tumor DNA analysis for detection of minimal residual disease after chemoradiotherapy for localized esophageal cancer[J]. Gastroenterology, 2020,158(3):494-505.
[4] van Velzen M J M, Creemers A, van den Ende T, et al. Circulating tumor DNA predicts outcome in metastatic gastroesophageal cancer[J]. Gastric Cancer, 2022,25(5):906-915.
[5] Hofste L S M, Geerlings M J, Rhein D, et al. Circulating tumor DNA-based disease monitoring of patients with locally advanced esophageal cancer[J]. Cancers(Basel), 2022,14(18),4417.
[6] Liu T, Yao Q Q, Jin H. Plasma circulating tumor DNA sequencing predicts minimal residual disease in resectable esophageal squamous cell carcinoma[J]. Front Oncol, 2021,11:616209.
[7] Ococks E, Sharma S, Ng A W T, et al. Serial circulating tumor DNA detection using a personalized, tumor-informed assay in esophageal adenocarcinoma patients following resection[J]. Gastroenterology, 2021,161(5):1705-1708.
[8] Cabalag C S, Yates M, Corrales M B, et al. Potential clinical utility of a targeted circulating tumor DNA assay in esophageal adenocarcinoma[J]. Ann Surg, 2022,276(2):e120-e126.
[9] Fan K M, Rimal J, Zhang P,et al. Stark differences in cancer epidemiological data between GLOBOCAN and GBD: emphasis on oral cancer and wider implications[J]. E Clinical Medicine, 2022,54:101673.
[10] Lagergren J, Smyth E, Cunningham D,et al. Oesophageal cancer[J]. Lancet, 2017,390(10110):2383-2396.
[11] Li J, Xu J, Zheng Y, et al. Esophageal cancer: epidemiology, risk factors and screening[J]. Chin J Cancer Res, 2021,33(5):535-547.
[12] Yang J, Liu X, Cao S, et al. Understanding esophageal cancer: the challenges and opportunities for the next decade[J]. Front Oncol, 2020,10:1727.
[13] Zhou J, Wang C, Lin G, et al. Serial circulating tumor DNA in predicting and monitoring the effect of neoadjuvant chemoradiotherapy in patients with rectal cancer: a prospective multicenter study[J]. Clin Cancer Res, 2021,27(1):301-310.
[14] Khakoo S, Carter P D, Brown G, et al. MRI tumor regression grade and circulating tumor DNA as complementary tools to assess response and guide therapy adaptation in rectal cancer[J]. Clin Cancer Res, 2020,26(1):183-192.
[15] Pazdirek F, Minarik M, Benesova L, et al. Monitoring of early changes of circulating tumor DNA in the plasma of rectal cancer patients receiving neoadjuvant concomitant chemoradiotherapy: evaluation for prognosis and prediction of therapeutic response[J]. Front Oncol, 2020,10:1028.
[16] Jahr S, Hentze H, Englisch S, et al. DNA fragments in the blood plasma of cancer patients: quantitations and evidence for their origin from apoptotic and necrotic cells[J]. Cancer Res, 2001,61(4):1659-1665.
[17] Yi X, Ma J, Guan Y,et al. The feasibility of using mutation detection in ctDNA to assess tumor dynamics[J]. Int J Cancer, 2017,140(12):2642-2647.
[18] Pazdirek F, Minarik M, Benesova L, et al. Monitoring of early changes of circulating tumor DNA in the plasma of rectal cancer patients receiving neoadjuvant concomitant chemoradiotherapy: evaluation for prognosis and prediction of therapeutic response[J]. Front Oncol, 2020,10:1028.
PDF(1654 KB)
