Abstract
While advances in treatment and diagnostics have improved prognosis in colorectal
cancer (CRC), room for advancement remains, highlighting the importance of improving
tools for early detection and treatment guidance. Current national guidelines rely
on stage-based treatment recommendations but fail to identify patients with lower
stage disease who have a higher likelihood of recurrence or those for whom additional
therapy may not be beneficial. Circulating tumor DNA (ctDNA) is an emerging noninvasive
blood-based assay, which can inform cancer status as a single time point and/or longitudinal
biomarker. ctDNA can be used for the diagnosis of cancer, detection of minimal/molecular
residual disease, molecular profiling, and assessing treatment response. In patients
for whom operative management is indicated, detectable ctDNA is associated with worse
survival outcomes. This review highlights the expanding field of ctDNA in CRC, underlining
pivotal data and areas with the need for more research that are key for colorectal
surgeons to understand.
Keywords
circulating tumor DNA - adjuvant chemotherapy - biomarker - colon cancer - liquid
biopsy
