Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Sep 27, 2026; 18(9): 120399
Published online Sep 27, 2026. doi: 10.4240/wjgs.120399
Published online Sep 27, 2026. doi: 10.4240/wjgs.120399
Postoperative circulating tumor DNA detection predicts recurrence and guides adjuvant chemotherapy duration in high-risk stage III colorectal cancer
Xiao-Xi Guo, Jian-Zhong Deng, Long-Qing Cheng, Yi-Ban Lin, Ting Cao, Jie-Lan Feng, Ya-Nan Gao, Xian-Sheng Yang, Department of Anorectal Surgery, The First People’s Hospital of Foshan (Southern University of Science and Technology Affiliated Foshan Hospital), Foshan 528248, Guangdong Province, China
Shan-Shan Liang, Department of Gastrointestinal Surgery, The First People’s Hospital of Foshan (Southern University of Science and Technology Affiliated Foshan Hospital), Foshan 528248, Guangdong Province, China
Author contributions: Guo XX and Deng JZ were responsible for study conception, data collection, statistical analysis, and manuscript drafting; Cheng LQ, Lin YB, Cao T, Feng JL, and Gao YN participated in patient recruitment, sample processing, and laboratory assays; Yang XS and Liang SS provided clinical supervision and critical revision of the manuscript; and all authors approved the final version and agreed to be accountable for all aspects of the work.
AI contribution statement: No AI tools were used in the conception, design, data acquisition, data analysis, interpretation, or writing of any portion of this manuscript. All content, including the text, figures, tables, and references, was generated, reviewed, and verified entirely by the authors, who assume full responsibility and accountability for the integrity, accuracy, originality, and scientific validity of the manuscript and all submitted materials.
Supported by the Foshan Self-funded Science and Technology Project, No. 2220001004876.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the First People’s Hospital of Foshan, approval No. Lun Shen Yan[2022] No. 57.
Informed consent statement: Informed consent was waived by the Institutional Review Board.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available due to institutional data protection policies, but de-identified data are available from the corresponding author (Shanshan Liang, lsshan5639@163.com) upon reasonable request and subject to approval by the Ethics Committee of the First People’s Hospital of Foshan.
Corresponding author: Shan-Shan Liang, BSc, Department of Gastrointestinal Surgery, The First People’s Hospital of Foshan (Southern University of Science and Technology Affiliated Foshan Hospital), No. 81 Lingnan Avenue, Chancheng District, Foshan 528248, Guangdong Province, China. lsshan5639@163.com
Received: April 8, 2026
Revised: May 22, 2026
Accepted: July 28, 2026
Published online: September 27, 2026
Processing time: 160 Days and 2.6 Hours
Revised: May 22, 2026
Accepted: July 28, 2026
Published online: September 27, 2026
Processing time: 160 Days and 2.6 Hours
Core Tip
Core Tip: Postoperative circulating tumor DNA (ctDNA) provides early risk stratification in high-risk stage III colorectal cancer. In this retrospective cohort of 50 patients with T4 or N2 disease, ctDNA positivity 4 weeks after surgery was independently associated with poorer recurrence-free survival and earlier recurrence, with an approximately fourfold higher adjusted recurrence risk. Exploratory analyses suggested that ctDNA status may help inform adjuvant capecitabine plus oxaliplatin duration, although no significant within-group differences were observed between 3 months and 6 months of treatment. These findings support ctDNA as a promising biomarker requiring prospective validation.