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Background <p>Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for minimal residual disease (MRD) detection in resected non-small cell lung cancer (NSCLC), offering potential for risk stratification and treatment optimization in the postoperative setting.</p> Objective <p>To conduct a systematic review and meta-analysis evaluating the prognostic value of postoperative ctDNA detection for recurrence-free survival and overall survival in patients with surgically resected NSCLC.</p> Methods <p>We systematically searched multiple databases including PubMed, Embase, Web of Science, Scopus, and Cochrane Library, identifying 1,640 initial records. After screening and eligibility assessment, 13 studies encompassing 1,309 patients were included in the quantitative synthesis.</p> Results <p>Immediate postoperative ctDNA detection (4 studies, <i>n</i> = 556) demonstrated a hazard ratio of 6.41 (95% CI: 4.18–9.83, <i>P</i> &lt; 0.00001, I<sup>2</sup> = 0%) for recurrence-free survival. MRD assessment (9 studies, <i>n</i> = 1,107) yielded HR = 5.48 (95% CI: 3.71–8.10, <i>P</i> &lt; 0.00001, I<sup>2</sup> = 38%). Longitudinal ctDNA monitoring (8 studies, n = 1,102) showed the strongest association with HR = 8.70 (95% CI: 6.03–12.54, <i>P</i> &lt; 0.00001, I<sup>2</sup> = 21%). Post-adjuvant chemotherapy ctDNA positivity (3 studies, <i>n</i> = 460) resulted in HR = 2.85 (95% CI: 1.56–5.21, <i>P</i> = 0.0006, I<sup>2</sup> = 0%). Overall survival analysis (5 studies) demonstrated HR = 4.47 (95% CI: 2.66–7.52, <i>P</i> &lt; 0.00001, I<sup>2</sup> = 0%).</p> Conclusions <p>Postoperative ctDNA detection independently predicts prognosis in resected NSCLC, consistently indicating recurrence risk and guiding adjuvant therapy decisions.</p>

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Prognostic value of postoperative circulating tumor DNA for recurrence-free survival in resected non-small cell lung cancer: a systematic review and meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月27日

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  • Atta Ullah Khan,
  • Intizor Avazmetova,
  • Mukhayya Ruzieva,
  • Barno Matchanova,
  • Asilbek Dauletbaev,
  • Erkin Bilalov,
  • Muhammad Ibrahim

摘要

Background

Circulating tumor DNA (ctDNA) has emerged as a promising biomarker for minimal residual disease (MRD) detection in resected non-small cell lung cancer (NSCLC), offering potential for risk stratification and treatment optimization in the postoperative setting.

Objective

To conduct a systematic review and meta-analysis evaluating the prognostic value of postoperative ctDNA detection for recurrence-free survival and overall survival in patients with surgically resected NSCLC.

Methods

We systematically searched multiple databases including PubMed, Embase, Web of Science, Scopus, and Cochrane Library, identifying 1,640 initial records. After screening and eligibility assessment, 13 studies encompassing 1,309 patients were included in the quantitative synthesis.

Results

Immediate postoperative ctDNA detection (4 studies, n = 556) demonstrated a hazard ratio of 6.41 (95% CI: 4.18–9.83, P < 0.00001, I2 = 0%) for recurrence-free survival. MRD assessment (9 studies, n = 1,107) yielded HR = 5.48 (95% CI: 3.71–8.10, P < 0.00001, I2 = 38%). Longitudinal ctDNA monitoring (8 studies, n = 1,102) showed the strongest association with HR = 8.70 (95% CI: 6.03–12.54, P < 0.00001, I2 = 21%). Post-adjuvant chemotherapy ctDNA positivity (3 studies, n = 460) resulted in HR = 2.85 (95% CI: 1.56–5.21, P = 0.0006, I2 = 0%). Overall survival analysis (5 studies) demonstrated HR = 4.47 (95% CI: 2.66–7.52, P < 0.00001, I2 = 0%).

Conclusions

Postoperative ctDNA detection independently predicts prognosis in resected NSCLC, consistently indicating recurrence risk and guiding adjuvant therapy decisions.