ArticleJTCVS open2026
Preoperative circulating tumor DNA detection and occult lymph node metastases in clinical stage I lung cancer: The lung DETECT study.
Article in JTCVS open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05254782 (From Liquid Biopsy to Cure), which is not on this map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
From Liquid Biopsy to Cure: Using ctDNA Detection of Minimal Residual Disease to Identify Patients for Curative Therapy After Lung Cancer Resection (ctDNALung-Detect)
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23 authors.
Funding
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Abstract
Objective: To investigate whether preoperative circulating tumor (ct)DNA detection is associated with pathologic upstaging, including occult lymph node (LN) metastases, in clinical stage I non-small cell lung cancer (NSCLC). We hypothesized that preoperative ctDNA detection may identify patients at increased risk of higher-stage disease, including occult nodal involvement, who may benefit from more comprehensive staging. Methods: CtDNA Lung DETECT (NCT05254782) is a multicenter prospective cohort study in patients with clinical stage I NSCLC and preoperative ctDNA detection, using a tumor-informed ctDNA assay collected preoperatively. All patients underwent guideline-concordant staging with positron emission tomography/computed tomography (CT), CT-guided biopsy, and/or endobronchial ultrasound (EBUS). Results: Between July 2021 and September 2024, 14 of 153 patients with preoperative clinical stage I NSCLC had occult LN metastases discovered. Of these 14 LN-positive patients, 7 had prior EBUS with LN sampling, all with negative cytologic results. The other 7 were diagnosed via CT-guided biopsy alone according to standard guidelines. Preoperative ctDNA in plasma was detected in 8 of the 14 LN-positive patients. In the larger cohort, 34 of 153 patients had ctDNA detected preoperatively, 24% of whom had occult LN metastases at time of resection. In contrast, only 5% of patients without detectable ctDNA prior to surgery had occult nodal involvement ( Conclusions: Preoperative ctDNA detection was associated with a higher likelihood of pathologic upstaging, including occult LN metastasis in patients with clinical stage I NSCLC. These findings support further evaluation of ctDNA as a complementary tool to refine risk stratification and guide decisions regarding invasive mediastinal staging or perioperative treatment in clinical stage 1 NSCLC.
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