Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response

Colorectal cancer is the third most common cancer worldwide, and its incidence continues to grow. Approximately one-third of patients with colorectal cancer develop liver metastases during the natural course of disease. Complete surgical resection is associated with very low mortality in colorectal...

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Main Authors: Yingying Huang, Wenzhuo Jia, Lijun Wang, Qiuxiang Ou, Xue Wu, Baocai Xing
Format: Article
Language:English
Published: SAGE Publishing 2021-06-01
Series:Therapeutic Advances in Gastrointestinal Endoscopy
Online Access:https://doi.org/10.1177/26317745211020279
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spelling doaj-b89771468fb041e280ff0134007c8f892021-06-02T21:33:39ZengSAGE PublishingTherapeutic Advances in Gastrointestinal Endoscopy2631-77452021-06-011410.1177/26317745211020279Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete responseYingying HuangWenzhuo JiaLijun WangQiuxiang OuXue WuBaocai XingColorectal cancer is the third most common cancer worldwide, and its incidence continues to grow. Approximately one-third of patients with colorectal cancer develop liver metastases during the natural course of disease. Complete surgical resection is associated with very low mortality in colorectal liver metastasis patients, but only a small fraction of colorectal liver metastasis patients fulfill the selection criteria for surgical treatment. We herein describe a high-risk stage-IV rectal carcinoma patient who was initially unresectable according to the National Comprehensive Cancer Network guidelines with a clinical risk score of 4 but received conversion surgery combined with systemic chemotherapy and achieved a favorable long-term clinical outcome (pathologic complete response) of approximately 28 months. Furthermore, serial circulating tumor DNA monitoring using next-generation sequencing provided a comprehensive view of the patient’s clinical and pathologic status for better clinical decision support over the course of the disease. The absence of circulating tumor DNA/cells after conversion surgery was correlated with pathologic complete response. This case study not only demonstrated that a curative oncosurgical approach could be considered for high-risk colorectal liver metastasis patients under specific circumstances but also highlighted the role of circulating tumor DNA monitoring to gain further insight into the evolution of a patient’s response over time.https://doi.org/10.1177/26317745211020279
collection DOAJ
language English
format Article
sources DOAJ
author Yingying Huang
Wenzhuo Jia
Lijun Wang
Qiuxiang Ou
Xue Wu
Baocai Xing
spellingShingle Yingying Huang
Wenzhuo Jia
Lijun Wang
Qiuxiang Ou
Xue Wu
Baocai Xing
Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
Therapeutic Advances in Gastrointestinal Endoscopy
author_facet Yingying Huang
Wenzhuo Jia
Lijun Wang
Qiuxiang Ou
Xue Wu
Baocai Xing
author_sort Yingying Huang
title Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
title_short Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
title_full Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
title_fullStr Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
title_full_unstemmed Clearance of circulating tumor DNA in a high-risk stage-IV rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
title_sort clearance of circulating tumor dna in a high-risk stage-iv rectal carcinoma patient with synchronous liver metastases after conversion surgery is correlated with pathologic complete response
publisher SAGE Publishing
series Therapeutic Advances in Gastrointestinal Endoscopy
issn 2631-7745
publishDate 2021-06-01
description Colorectal cancer is the third most common cancer worldwide, and its incidence continues to grow. Approximately one-third of patients with colorectal cancer develop liver metastases during the natural course of disease. Complete surgical resection is associated with very low mortality in colorectal liver metastasis patients, but only a small fraction of colorectal liver metastasis patients fulfill the selection criteria for surgical treatment. We herein describe a high-risk stage-IV rectal carcinoma patient who was initially unresectable according to the National Comprehensive Cancer Network guidelines with a clinical risk score of 4 but received conversion surgery combined with systemic chemotherapy and achieved a favorable long-term clinical outcome (pathologic complete response) of approximately 28 months. Furthermore, serial circulating tumor DNA monitoring using next-generation sequencing provided a comprehensive view of the patient’s clinical and pathologic status for better clinical decision support over the course of the disease. The absence of circulating tumor DNA/cells after conversion surgery was correlated with pathologic complete response. This case study not only demonstrated that a curative oncosurgical approach could be considered for high-risk colorectal liver metastasis patients under specific circumstances but also highlighted the role of circulating tumor DNA monitoring to gain further insight into the evolution of a patient’s response over time.
url https://doi.org/10.1177/26317745211020279
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