ArticleJournal of experimental & clinical cancer research : CR2024
Role of cfDNA and ctDNA to improve the risk stratification and the disease follow-up in patients with endometrial cancer: towards the clinical application.
Article in Journal of experimental & clinical cancer research : CR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Unveiling the Prognostic Power of Circulating Tumor DNA in Multiple Myeloma: A Systematic Review and Updated Meta-Analysis.Cancer medicine · 2026Pooled it
- DNA-Based Liquid Biopsy for Evaluating Surgical and Postsurgical Outcomes in Gynecologic Malignancies: A Systematic Review.Journal of clinical laboratory analysis · 2026Pooled it
- Circulating immune profiling reveals immune signatures associated with disease stage and outcome in endometrial cancer.The journal of liquid biopsy · 2026Article
- Liquid Biopsy for Minimal Residual Disease Assessment in Endometrial and Cervical Cancers: Molecular Rationale, Clinical Evidence, and Translational Barriers.International journal of molecular sciences · 2026Review
- Neutrophil extracellular traps (NETosis) in gynecologic cancers: from pathogenesis to therapeutic opportunities: a narrative review.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- Liquid Biopsy Biomarkers in Endometrial Cancer: Current Landscape and Future Perspectives.Biomolecules · 2026Review
- Detection of recurrent endometrial cancer via DNA methylation analysis of cervicovaginal self-samples and urine.International journal of cancer · 2026Article
- The Clinical Utility of Cell-Free DNA in Brain Tumor Management: A Comprehensive Review.Journal of molecular neuroscience : MN · 2025Review
- Integrating Multi-Omics in Endometrial Cancer: From Molecular Insights to Clinical Applications.Cells · 2025Review
- Management of Advanced Stage Endometrial Cancer With Non-Measurable Disease After Surgery.Current treatment options in oncology · 2025Review
- Beyond the Microscope: Integrating Liquid Biopsies into the Molecular Pathology Era of Endometrial Cancer.International journal of molecular sciences · 2025Review
- Genome-wide cfDNA fragmentation patterns in cerebrospinal fluid reflect medulloblastoma groups.NPJ precision oncology · 2025Article
- Unlocking the Potential of Liquid Biopsy: A Paradigm Shift in Endometrial Cancer Care.Diagnostics (Basel, Switzerland) · 2025Review
- Liquid biopsy in gynecological cancers: a translational framework from molecular insights to precision oncology and clinical practice.Journal of experimental & clinical cancer research : CR · 2025Review
- Updates and controversies in the management of uterine serous carcinoma and uterine carcinosarcoma.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2025Review
- Remodeling the tumor microenvironment: regulatory effects of β-sitosterol and luteolin on the immunosuppressive milieu in endometrial carcinoma and implications for combinatorial immunotherapy.Frontiers in immunology · 2025Review
- Neutrophil extracellular traps in diseases of the female reproductive organs.Frontiers in immunology · 2025Review
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Authors and funding
26 authors.
Funding
Abstract
backgroundThere has been a rise in endometrial cancer (EC) incidence leading to increased mortality. To counter this trend, improving the stratification of post-surgery recurrence risk and anticipating disease relapse and treatment resistance is essential. Liquid biopsy analyses offer a promising tool for these clinical challenges, though the best strategy for applying them in EC must be defined. This study was designed to determine the value of cfDNA/ctDNA monitoring in improving the clinical management of patients with localized and recurrent disease.
methodsPlasma samples and uterine aspirates (UA) from 198 EC patients were collected at surgery and over time. The genetic landscape of UAs was characterized using targeted sequencing. Total cfDNA was analyzed for ctDNA presence based on the UA mutational profile.
resultsHigh cfDNA levels and detectable ctDNA at baseline correlated with poor prognosis for DFS (p-value < 0.0001; HR = 9.25) and DSS (p-value < 0.0001; HR = 11.20). This remained clinically significant when stratifying tumors by histopathological risk factors. Of note, cfDNA/ctDNA analyses discriminated patients with early post-surgery relapse and the ctDNA kinetics served to identify patients undergoing relapse before any clinical evidence emerged.
conclusionsThis is the most comprehensive study on cfDNA/ctDNA characterization in EC, demonstrating its value in improving risk stratification and anticipating disease relapse in patients with localized disease. CtDNA kinetics assessment complements current strategies to monitor the disease evolution and the treatment response. Therefore, implementing cfDNA/ctDNA monitoring in clinical routines offers a unique opportunity to improve EC management. TRANSLATIONAL RELEVANCE: The study demonstrates that high levels of cfDNA and detectable ctDNA at baseline are strong indicators of poor prognosis. This enables more accurate risk stratification beyond traditional histopathological factors, allowing clinicians to identify high-risk patients who may benefit from more aggressive treatment and closer monitoring. Moreover, longitudinal analysis of cfDNA/ctDNA can detect disease recurrence months before clinical symptoms or imaging evidence appear. This early warning system offers a significant advantage in clinical practice, providing a window of opportunity for early intervention and potentially improving patient outcomes.
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