ArticleMolecular oncology2020
The effect of surgical trauma on circulating free DNA levels in cancer patients-implications for studies of circulating tumor DNA.
Article in Molecular oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 5 of them syntheses that pooled it.
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Who cites it
108 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Circulating tumour DNA for a minimal residual disease assessment and recurrence risk in hepatocellular carcinoma: a systematic review and meta-analysis.British journal of cancer · 2026Pooled it
- Clinical Practice Guideline for Blood-based Circulating Tumor DNA Assays.Annals of laboratory medicine · 2024Guideline
- Circulating Tumour DNA as Biomarker for Colorectal Liver Metastases: A Systematic Review and Meta-Analysis.Cells · 2023Pooled it
- Utility of ctDNA in predicting relapse in solid tumors after curative therapy: a meta-analysis.JNCI cancer spectrum · 2023Pooled it
- Circulating tumour DNA as biomarker for rectal cancer: A systematic review and meta-analyses.Frontiers in oncology · 2023Pooled it
- Tumor-Free Circulating Tumor DNA in Node-Negative Rectal Cancers Undergoing Neoadjuvant Chemotherapy, Excision, and Observation in the Phase II NEO Trial (CO.28).JCO precision oncology · 2026Trial
- Adjuvant treatment intensity in circulating tumour DNA-negative colorectal cancer: a systematic review and reconstructed individual patient data meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- Assessment of MRD and Longitudinal Monitoring of Post-Surgery Biliary Tract Cancer With a Customized ctDNA Panel.Cancer science · 2026Article
- Postoperative ctDNA in Resectable Gastric Cancer: Prognostically Powerful, but Not Yet Actionable.Digestive diseases and sciences · 2026Article
- Perioperative ctDNA as a prognostic biomarker in endometrial cancer - the CODEC study.Translational oncology · 2026Article
- Impact of methodological variability on the prognostic performance of circulating tumor DNA in colorectal cancer: A systematic review and meta-analysis.The journal of liquid biopsy · 2026Review
- Review
- Baseline value and longitudinal kinetics of circulating nucleosomes during neo-adjuvant chemotherapy in newly diagnosed ovarian cancer: Results from a GINECO/GINEGEPS study of the randomized phase II CHIVA trial.Translational oncology · 2026Article
- Liquid Biopsy in Resected Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.Annals of surgical oncology · 2026Article
- Liquid biopsy in colorectal cancer: redefining surgical decision-making.Updates in surgery · 2026Review
- An alignment-free strategy for circulating tumor DNA detection and tumor fraction estimation from whole-genome sequencing data.PLoS computational biology · 2026Article
- Circulating Tumor DNA Sequencing for Early Diagnosis and Detection of Treatment Response, Minimal Residual Disease, and Recurrence in Gastroesophageal Cancer.Journal of gastrointestinal cancer · 2026Review
- Review
- Post-surgery level of circulating DNA in stage III colon cancer patients: Impact on the reliability of minimal residual disease detection.International journal of cancer · 2026Article
- [Research Advances in ctDNA-MRD Monitoring in Local Treatment for Non-small Cell Lung Cancer].Zhongguo fei ai za zhi = Chinese journal of lung cancer · 2026Review
48 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
Abstract
Detection of circulating tumor DNA (ctDNA) post-treatment is an emerging marker of residual disease. ctDNA constitutes only a minor fraction of the cell-free DNA (cfDNA) circulating in cancer patients, complicating ctDNA detection. This is exacerbated by trauma-induced cfDNA. To guide optimal blood sample timing, we investigated the duration and magnitude of surgical trauma-induced cfDNA in patients with colorectal or bladder cancer. DNA levels were quantified in paired plasma samples collected before and up to 6 weeks after surgery from 436 patients with colorectal cancer and 47 patients with muscle-invasive bladder cancer. To assess whether trauma-induced cfDNA fragments are longer than ordinary cfDNA fragments, the concentration of short (< 1 kb) and long (> 1 kb) fragments was determined for 91 patients. Previously reported ctDNA data from 91 patients with colorectal cancer and 47 patients with bladder cancer were used to assess how trauma-induced DNA affects ctDNA detection. The total cfDNA level increased postoperatively-both in patients with colorectal cancer (mean threefold) and bladder cancer (mean eightfold). The DNA levels were significantly increased up to 4 weeks after surgery in both patient cohorts (P = 0.0005 and P ≤ 0.0001). The concentration of short, but not long, cfDNA fragments increased postoperatively. Of 25 patients with radiological relapse, eight were ctDNA-positive and 17 were ctDNA-negative in the period with trauma-induced DNA. Analysis of longitudinal samples revealed that five of the negative patients became positive shortly after the release of trauma-induced cfDNA had ceased. In conclusion, surgery was associated with elevated cfDNA levels, persisting up to 4 weeks, which may have masked ctDNA in relapse patients. Trauma-induced cfDNA was of similar size to ordinary cfDNA. To mitigate the impact of trauma-induced cfDNA on ctDNA detection, it is recommended that a second blood sample collected after week 4 is analyzed for patients initially ctDNA negative.
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