Prospective study of prognostic significance of pretreatment KRAS-mutant ctDNA in patients undergoing radiofrequence ablation for CRLM

A prospective study at the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) evaluated the prognostic significance ofpretreatment KRAS-mutant circulating tumor DNA (ctDNA) in predicting recurrence incidence and patterns in patients with colorectal liver metastases (CRLM) undergoing radiofrequency ablation (RFA). The study enrolled 78 patients undergoing curative-intent RFA. Pretreatment ctDNA was detected in 21 patients (26.9%). Patients who harbored KRAS-mutant ctDNA exhibited significantly higher recurrence rates (71.4% versus 31.6%; p=0.004) and shorter median progression-free survival (352 days versus not reached; p<0.001). In multivariate analysis, more than 3 hepatic lesions (aHR 7.66; pxtagstartz0.001) and positive ctDNA status (aHR 3.20; p=0.001) were independent predictors if recurrence. Moreover, ctDNA-positive patients predominantly developed lung metastases (60%), while ctDNA-negative patients showed liver-dominant recurrence (61.1%). The authors conclude that pretreatment