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Cancer Genomics and Diagnostics / Cancer Cells and Metastasis / Esophageal Cancer Research and Treatment · Journal article
Annals of Laboratory Medicine · August 18, 2026
Encouraging direction, but not yet definitive.
This prospective study of 84 surgically treated ESCC patients demonstrates that ctDNA detection by customized 27-gene panel correlates with pathological stage and is present in 75% of recurrent cases, with lead time of 3–6 months over radiological imaging in three cases. The findings are suggestive of clinical utility for recurrence monitoring but require validation in larger, comparative cohorts before changing practice.
Prospective cohort study. Eighty-four patients with pathologically confirmed ESCC who underwent curative resection; mean age 63.7±8.3 years, 92.9% male, 41.7% pathological stage 0–I, 31.0% stage II, 26.2% stage III–IV, 10.7% received neoadjuvant therapy.. Intervention: ctDNA detection by customized 27-gene panel sequencing at diagnosis and during 4-month interval follow-up.. n = 84.
ctDNA variants detected in 31 of 84 patients (36.9%) at initial diagnosis Detection rate 63.6% in advanced stages (III–IV) versus 28.3% in early-stage cancers (0–I) 18 of 24 recurrent patients (75%) harbored detectable ctDNA variants
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ctDNA detection may provide an adjunct to imaging surveillance for recurrence in ESCC, with potential to identify recurrence months earlier in some patients. However, sensitivity is incomplete (75% in recurrent cases) and clinical outcomes (survival, intervention triggered by early detection) are not reported; current use should be exploratory pending validation.
A prospective single-centre study in 84 ESCC patients shows ctDNA detection correlates with stage and precedes radiological recurrence in some cases, but lacks a formal comparator group and hard clinical outcome validation.
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Quoted from the source exactly as published.
ctDNA detection may provide an adjunct to imaging surveillance for recurrence in ESCC, with potential to identify recurrence months earlier in some patients. However, sensitivity is incomplete (75% in recurrent cases) and clinical outcomes (survival, intervention triggered by early detection) are not reported; current use should be exploratory pending validation.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background: Esophageal squamous cell carcinoma (ESCC) is associated with a high recurrence rate and is one of the most aggressive malignancies. Recurrence is mainly detected via imaging modalities; however, postoperative imaging surveillance has disadvantages, including reduced sensitivity in postoperative or irradiated tissues, high cost, and repeated radiation exposure. Research elucidating the diagnostic utility of circulating tumor DNA (ctDNA) in ESCC remains limited. In this prospective study, we evaluated the clinical value of ctDNA as a biomarker for ESCC diagnosis and longitudinal monitoring. Methods: Eighty-four patients with pathologically confirmed ESCC who underwent curative resection were prospectively enrolled (mean age, 63.7±8.3 yrs; men, 92.9%; pathological stage 0-I, 41.7%; II, 31.0%; III-IV, 26.2%; neoadjuvant therapy, 10.7%). In total, 334 samples (84 at initial diagnosis and 250 during follow-up at 4-month intervals with computed tomography) were analyzed. Ultra-high-depth sequencing (mean effective depth, >30,000×) was performed using a customized panel targeting 27 ESCC-related genes. Matched leukocyte DNA was used to exclude germline and clonal hematopoiesis variants; variants with allele frequencies ≥ 0.25% were interpreted according to the AMP/ASCO/CAP tiers. Results: ) were detected in 31 patients (36.9%). Detection rates were higher in advanced stages (63.6%) than in early-stage cancers (28.3%). While the initial ctDNA detection rate correlated with pTNM stages, no significant association was found with other pathological features. Follow-up assessments revealed that 18 of 24 patients with recurrence (75%) harbored detectable ctDNA variants. Notably, in three cases, ctDNA positivity preceded radiological recurrence by 3-6 months. Conclusions: The ctDNA detection rate using a customized gene panel correlated with tumor burden. Accordingly, ctDNA may be helpful for monitoring recurrence in patients with ESCC.
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