The Prognostic Value of Circulating Cell-Free DNA in Colorectal Cancer: A Meta-Analysis.
BACKGROUND
Circulating cell-free DNA (cfDNA) is a promising candidate biomarker for detection, monitoring and survival prediction of colorectal cancer (CRC). However, its prognostic significance for patients with CRC remains controversial. To derive a precise estimation of the prognostic significance of cfDNA, a meta-analysis was performed.


METHODS
We made a systematic search in data base of the Science Citation Index Embase and Pubmed for studies reporting prognostic data of cfDNA in CRC patients. The data of cfDNA on recurrences-free survival (RFS) and overall survival (OS) were extracted and measured in hazard rates (HRs) and 95% confident intervals (CIs). Subgroup analyses were carried out as well. Finally, the meta-analysis is accompanied with nine studies including 19 subunits.


RESULTS
The pooled HRs with 95% CIs revealed strong associations between cfDNA and RFS (HR [95%CI]=2.78[2.08-3.72], I(2)=32.23%, n=7) along with OS (HR [95%CI]=3.03[2.51-3.66], I(2)=29.24%, n=12) in patients with CRC. Entire subgroup analyses indicated strong prognostic value of cfDNA irrespective tumor stage, study size, tumor markers, detection methods and marker origin.


CONCLUSIONS
All the results exhibits that appearance of cfDNA in blood is an indicator for adverse RFS and OS in CRC patients.
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China;
Shiva
S
Basnet
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China;
Zhen-Yu
ZY
Zhang
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China;
Wen-Qiang
WQ
Liao
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China;
Shu-Heng
SH
Li
2. Department of Research Administration, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.
Ping-Shu
PS
Li
1. Department of Gastrointestinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China;
Hai-Yan
HY
Ge
Plasma DNA; cell-free DNA; colorectal cancer; meta-analysis.; prognosis