Adjuvant Chemotherapy and Overall Survival in High Risk Stage Ii Colon Cancer

Verhoeff, Sarah R.; Erning, F. van; Pruijt, J.F.M.; Wilt, J. De; Lemmens, Valery

doi:10.1093/annonc/mdu333.77

Cited by 1 publication

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“…However, these diagnostic methods frequently fail to capture patients with micrometastatic disease who will recur without additional intervention. This notion is particularly true for patients with stage I disease, where current guidance forgoes radiographic monitoring, and little data exists regarding the risk for recurrence (1)(2)(3)(4)(5). In the clinical case presented above, serial ctDNA measurement prompted additional imaging, leading to earlier intervention, with aggressive systemic therapy as a bridge to definitive treatment.…”

Section: Discussionmentioning

confidence: 99%

Post-operative ctDNA monitoring in stage I colon cancer: A case report

et al. 2022

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Circulating tumor DNA (ctDNA) level monitoring after surgery for colon cancer has been studied in stage II and III colon cancer to risk-stratify patients for adjuvant therapy. However, there is less data regarding the role of this diagnostic tool in the management of stage I disease, where current recommended surveillance is limited to screening colonoscopy at one year. In this report, we describe the case of a 57-year-old man with stage I colon cancer who underwent complete resection with adequate lymph node surgical sampling, normal preoperative CEA and no evidence of metastatic disease on initial imaging. The patient elected to undergo serial ctDNA monitoring after surgery. Rising ctDNA levels, five months after resection, prompted cross-sectional imaging which demonstrated metastatic disease to the liver. The patient subsequently received five cycles of leucovorin, 5-fluorouracil, oxaliplatin, and irinotecan with bevacizumab (FOLFOXIRI-Bev) and definitive microwave ablation to the liver metastases, with resulting undetectable ctDNA levels. The patient’s imaging and colonoscopy one-year post-operatively showed no evidence of disease, with ctDNA levels remaining undetectable. This report highlights the value of ctDNA monitoring in patients with early-stage colon cancer and suggests that further, large-scale studies may be warranted to determine its appropriate clinical use.

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Section: Discussionmentioning

confidence: 99%