Evidence map›Paper›PMID 42665699›Full record

ArticleAnnals of surgical oncology2026

Liquid Biopsy in Resected Pancreatic Ductal Adenocarcinoma: A Systematic Review and Meta-Analysis.

Jiage Qian, Sebastiaan Ceuppens, Nikhil V Tirukkovalur, Hong-Zhang He, Si-Yang Zheng, Rachel Suppok, Bas Groot Koerkamp, Amer H Zureikat, Alessandro Paniccia

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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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0citing papers in PubMed
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1 · What the graph read from it

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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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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

9 authors.

Jiage Qian *Department of Surgery, Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, USA.
Sebastiaan Ceuppens *Department of Surgery, Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, USA.
Nikhil V TirukkovalurDepartment of Surgery, Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, USA.
Hong-Zhang HeDepartment of Biomedical engineering, Carnegie Mellon University, Pittsburgh, USA.
Si-Yang ZhengDepartment of Biomedical engineering, Carnegie Mellon University, Pittsburgh, USA.
Rachel SuppokHealth Sciences Library System, University of Pittsburgh, Pittsburgh, USA.
Bas Groot KoerkampDepartment of Surgery, Erasmus Medical Center, Rotterdam, Rotterdam, The Netherlands.
Amer H ZureikatDepartment of Surgery, Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, USA.
Alessandro PanicciaDepartment of Surgery, Division of GI Surgical Oncology, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, USA. panicciaa2@upmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDistinct liquid biopsy modalities are emerging as promising tumor-specific biomarkers to monitor treatment response and predict survival in pancreatic ductal adenocarcinoma (PDAC). Circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and extracellular vesicles (EVs) may reflect underlying systemic disease burden and complement conventional imaging or CA19-9 assessment. This systematic review and meta-analysis evaluated the prognostic significance of liquid biopsy biomarkers in patients with resected PDAC.

methodsA systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Studies published until 1 July 2025 evaluating ctDNA, CTCs, or EVs in patients with resected PDAC, with or without neoadjuvant therapy, were evaluated. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Study quality was assessed using the QUADAS-2 tool.

resultsThe meta-analysis included 44 studies (26 ctDNA, 12 CTC, and 6 EV studies; >2,500 patients). Preoperative ctDNA positivity was associated with worse OS (pooled hazard ratio [HR], 2.53; 95% confidence interval [CI], 1.86-3.44) and RFS (HR, 2.28; 95% CI, 1.67-3.11), with low-to-moderate heterogeneity. Postoperative ctDNA positivity demonstrated stronger associations with worse OS (HR, 5.15; 95% CI, 1.57-16.88) and RFS (HR, 3.12; 95% CI, 2.01-4.82), with moderate-to-substantial heterogeneity. Preoperative CTC positivity was associated with inferior RFS (HR, 2.70; 95% CI, 1.32-5.52), with substantial heterogeneity. In individual studies, EV-based biomarkers demonstrated consistent adverse outcomes. However, quantitative pooling was not feasible due to marked heterogeneity.

conclusionIn resected PDAC, preoperative ctDNA is a robust predictor of recurrence and survival. Both CTCs and EVs show biologically compelling but assay-dependent prognostic signals.

Indexed as

AdenocarcinomaCTCctDNAExtracellular VesicleLiquid BiopsyPancreatic CancerSurvival Outcome

Identifiers

PMID42665699

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