Evidence map›Paper›PMID 42324366›Full record

ArticleAnnals of surgical oncology2026

Preoperative Tumor-Informed ctDNA for Prediction of Nodal Metastases at Radical Cystectomy in Bladder Cancer.

Can Aydogdu, Betty Wang, Sean McSweeney, Alberto Pieretti, Christopher J Weight, Riccardo Autorino, Jihad Kaouk, Laura Bukavina

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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Can AydogduDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Betty WangDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Sean McSweeneyDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Alberto PierettiDepartment of Urology, Weston Hospital, Cleveland Clinic Florida, Weston, FL, USA.
Christopher J WeightDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Riccardo AutorinoDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Jihad KaoukDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA.
Laura BukavinaDepartment of Urology, Integrated Surgical Institute, Cleveland Clinic, Cleveland, OH, USA. bukavil2@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to evaluate whether pre-surgical tumor-informed circulating tumor DNA (ctDNA) predicts pathologic nodal status at radical cystectomy and its potential role in risk stratification for future biomarker-guided surgical strategies.

methodsThe study prospectively analyzed 40 patients with non-muscle-invasive and muscle-invasive bladder cancer who underwent radical cystectomy with pelvic lymph node dissection (LND) and pre-surgical tumor-informed ctDNA testing. Compared with pathologic nodal findings, ctDNA status was classified as positive or negative. Diagnostic performance metrics with 95 % confidence intervals (CIs) were calculated. To assess reproducibility, data from a published cohort meeting comparable inclusion criteria were integrated for pooled descriptive analysis.

resultsOf 40 patients, 27 (68 %) were ctDNA-negative and 13 (32 %) were ctDNA-positive before cystectomy. Pathologic nodal metastases were identified in seven patients (18 %). For nodal metastases, ctDNA demonstrated a sensitivity of 86 % (95 % CI, 49-97 %), a specificity of 79 % (95 % CI, 62-89 %), and negative predictive value of 96 % (95 % CI, 82-99 %). In pooled descriptive analysis including 149 patients, the negative predictive value remained high at 92 % (95 % CI, 84-97 %). A simulated ctDNA-guided omission strategy may have avoided LND for 27 patients (68 %), with one false-negative case (3.7 %) that subsequently had recurrence.

conclusionPre-surgical tumor-informed ctDNA showed high negative predictive value for nodal metastases at radical cystectomy. These findings supported prospective validation of ctDNA as a biomarker to identify patients at low risk of nodal metastases and inform future trials of biomarker-guided surgical strategies.

Indexed as

Biomarkers, TumorCirculating Tumor DNACystectomyUrinary Bladder NeoplasmsAgedFemaleFollow-Up StudiesHumansLymphatic MetastasisLymph Node ExcisionMaleMiddle AgedNon-Muscle Invasive Bladder NeoplasmsPreoperative CarePrognosisProspective StudiesBiomarkers, TumorCirculating Tumor DNABladder cancerCirculating tumor DNAMolecular residual diseaseNodal metastasisPelvic lymph node dissectionPrecision surgeryRadical cystectomyRisk stratification

Identifiers

PMID42324366
PMCPMC13585835

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