Retrospective study of prognostic value of preoperative ctDNA and pathological venous invasion for recurrence in EGFR-mutated non-small cell lung cancer

A retrospective study at Kazanawa University Hospital (Japan) evaluated the utility of preoperative circulating tumor DNA (ctDNA) and pathological venous invasion to predict recurrence in patients after resection of pathological stage I-III EGFR-mutated non-small cell lung cancer (NSCLC). Among 88 patients, preoperative ctDNA positivity was detecten in 26.1% and venous invasion in 39.8%. With follow-up up to 6.4 years, preoperative ctDNA-positive patients had lower 60-month disease-free survival rate (54.1% versus 84.1%; HR 3.25; p=0.028) and 60-month overall survival rate (65.1% versus 95.9%; HR 6.10; p=0.037) compared with ctDNA-negative patients. Venous invasion was independently associated with poorer disease-free survival (HR 8.83; p=0.0068). In combined analysis, no recurrences occurred in the double-negative group, whereas the double-positive group had lower 60-month disease-free survival rate than the single-positive group (HR 3.61; p=0.023). The authors conclude that preoperative ctDNA detection and pathological venous invasion provide complementary prognostic information in EGFR-mutated NSCLC.