{
  "abstract": "Background: The early detection of molecular residual disease (MRD) is critical for predicting recurrence and guiding management in colorectal cancer (CRC). We aimed to evaluate the performance of tumor-informed circulating tumor DNA (ctDNA) analysis in monitoring MRD after curative-intent surgery. Methods: In this cohort study of 28 resected CRC patients, tumor-informed variants were identified from formalin-fixed paraffin-embedded (FFPE) or fresh-frozen (FF) tissues using whole-genome sequencing. Post-operative plasma ctDNA was analyzed with the next-generation sequencing-based AccuScan platform at landmark (2–6 weeks) and longitudinal time points. Results: ctDNA-based MRD detection achieved 100% specificity (95% CI: 78.2–100%) and positive predictive value for recurrence in this cohort of 28 patients, which included 13 recurrence events with a median follow-up of 36.2 months. Sensitivity was 83.3% (95% CI: 35.9–99.6%) for patients with FFPE-guided analysis (n = 13) and 85.7% (95% CI: 42.1–99.6%) for the combined cohort (FFPE- and/or FF-guided analysis (n = 20) at the landmark time point, improving to 88.9% and 92.3%, respectively, with longitudinal monitoring. MRD-positive status was associated with significantly reduced disease-free survival (p < 0.0001) in unadjusted analyses. Although FFPE-derived sequencing introduced more artifacts, bioinformatic filtering preserved assay accuracy, and the concurrent use of both reference types in a subset of patients highlighted the potential to improve overall detection sensitivity. Conclusions: These findings suggest that tumor-informed ctDNA analysis provides a promising approach for post-operative MRD surveillance and recurrence risk stratification in CRC. However, the small sample size, lack of external validation, and absence of neoadjuvant-treated patients preclude definitive conclusions. Independent prospective validation is required.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong SAR, China",
    "Department of Research and Development, AccuraGen Inc., San Jose, CA, USA",
    "Department of Surgery, University of Hong Kong, Hong Kong SAR, China"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "William C. Cho",
      "orcid": "0000-0003-4174-4586"
    },
    {
      "affs": [
        1
      ],
      "name": "Yingyu Wang"
    },
    {
      "affs": [
        1
      ],
      "name": "Qianqian Yao"
    },
    {
      "affs": [
        1
      ],
      "name": "Tam Berntsen"
    },
    {
      "affs": [
        1
      ],
      "name": "George Yeung"
    },
    {
      "affs": [
        1
      ],
      "name": "Paul Tang"
    },
    {
      "affs": [
        1
      ],
      "name": "Tobias Wittkop"
    },
    {
      "affs": [
        1
      ],
      "name": "Li Weng"
    },
    {
      "affs": [
        2
      ],
      "name": "Lui Ng",
      "orcid": "0000-0002-9010-2654"
    },
    {
      "affs": [
        2
      ],
      "name": "Dominic C. C. Foo",
      "orcid": "0000-0001-8849-6597"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ecg0e2cb44zf0.bib",
  "cited_by": 0,
  "doi": "10.32604/or.2026.080218",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732390/",
  "id": "ecg0e2cb44zf0",
  "issns": [
    "0965-0407",
    "1555-3906"
  ],
  "landing_url": "https://doi.org/10.32604/or.2026.080218",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Article"
    ],
    [
      "openalex",
      "1306|Cancer Genomics and Diagnostics"
    ]
  ],
  "openalex": "W7203672983",
  "pdf_url": "https://www.techscience.com/or/online/detail/28000/pdf",
  "pmcid": "PMC13732390",
  "pmid": "42984935",
  "published": "2026-10-28",
  "publisher": "Tech Science Press",
  "ris": "https://research.draconitic.com/paper/ecg0e2cb44zf0.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:23Z",
      "native_id": "PMC13732390",
      "source": "pmc",
      "url": "https://doi.org/10.32604/or.2026.080218"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:1306|Cancer Genomics and Diagnostics",
      "subfield": "oncology"
    }
  ],
  "title": "Monitoring Molecular Residual Disease in Colorectal Cancer Using Tumor-Informed ctDNA Analysis",
  "title_text": "Monitoring Molecular Residual Disease in Colorectal Cancer Using Tumor-Informed ctDNA Analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:23Z",
  "url": "https://research.draconitic.com/paper/ecg0e2cb44zf0",
  "venue": "Oncology Research",
  "versions": []
}