Introduction
Colorectal cancer frequently spreads to the liver, and surgical removal of these liver metastases (colorectal liver metastases, CRLM) offers a chance for long-term survival. However, deciding which patients benefit from additional treatment after surgery, namely adjuvant chemotherapy (ACT), remains controversial. Although ACT can reduce recurrence risk, its impact on overall survival (OS) has been inconsistent in clinical studies, and there is no standard tool for identifying patients who truly benefit.
Circulating tumor DNA (ctDNA) analysis has emerged as a promising biomarker to detect minimal residual disease (MRD) — tiny amounts of cancer DNA remaining in the body after surgery, which might indicate a higher risk of relapse. Personalized, tumor-informed ctDNA testing can sensitively detect MRD and guide informed clinical decision-making. This study evaluates the relationship between ctDNA-defined MRD status, survival outcomes, and the benefit of ACT in patients who have undergone curative surgery for CRLM.
