Dizdarevic Edina, Hansen Torben Frøstrup, Jakobsen Anders
Danish Colorectal Cancer Center South, Department of Oncology, University Hospital of Southern Denmark, 7100 Vejle, Denmark.
Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark.
Cancers (Basel). 2022 Apr 30;14(9):2252. doi: 10.3390/cancers14092252.
The treatment of locally advanced rectal cancer (LARC) has evolved during the last decades, but recurrence remains a problem. Circulating tumor DNA (ctDNA) may result in an individualized treatment approach with improved survival and quality of life, but diverging results impede further development. In this systematic review, we addressed the quality of reporting and its impact on the interpretation of ctDNA results. We performed a systematic literature search using subject headings and search terms related to ctDNA and rectal cancer. The Quality of Prognostic Studies (QUIPS) tool was used to assess bias. Nine studies, with substantial heterogeneity, were included in the analysis. Three out of nine articles had moderate or high risk of bias. No association was found between treatment response and ctDNA status at baseline. There was a negative association between ctDNA positivity at baseline, before and after surgery and survival. The ctDNA status may be of importance to the long-term prognosis, but the area of research is new and is short of dedicated studies. There is an obvious need for standardization in ctDNA research, and the issue should be addressed in future research.
在过去几十年中，局部晚期直肠癌（LARC）的治疗方法不断演变，但复发仍是一个问题。循环肿瘤DNA（ctDNA）可能会带来一种个性化的治疗方法，从而提高生存率和生活质量，但结果存在差异阻碍了其进一步发展。在这项系统评价中，我们探讨了报告质量及其对ctDNA结果解读的影响。我们使用与ctDNA和直肠癌相关的主题词和检索词进行了系统的文献检索。采用预后研究质量（QUIPS）工具评估偏倚。九项研究纳入分析，异质性较大。九篇文章中有三篇存在中度或高度偏倚风险。在基线时，未发现治疗反应与ctDNA状态之间存在关联。基线时、手术前后ctDNA阳性与生存率之间存在负相关。ctDNA状态可能对长期预后很重要，但该研究领域尚新，缺乏专门研究。ctDNA研究显然需要标准化，这一问题应在未来研究中加以解决。
