Am J Clin Oncol: Meth-ctDNA or potential prognosis marker for advanced rectal cancer.

For localized late-stage rectal cancer, long-term prevention of disease metastasis remains a challenge and there is a lack of strong metastatic progression of pre-treatment prognosis.
we speculate that low methylation (meth-ctDNA) based on the neuropeptide Y gene can be a prognostice marker in a new auxiliary treatment environment, which we have studied in a prospective trial's secondary exploratory analysis.
a prospective collection of serum samples in a Phase III trial for localized late-stage rectal cancer.
estimated positive and partial abundance of thyroid ctDNA in baseline samples.
compared the total survival (OS) of meth-ctDNA-positive and negative patients with the distant metastasis rate;
investigates the importance of quantitative load by considering the component abundance of meth-ct DNA relative to total circulating DNA.
results showed that baseline serum samples were available for 146 patients.
a total of 30 patients had methyl-ctDNA, which was not associated with the cT (P-0.8) or cN (P-0.6) stage.
median follow-up OS was 10.6 years and no distance shiftwas at 5.1 years.
5-year OS was significantly worse in patients with thyroid ctDNA (47 percent vs. 69 percent), even if other prognosis factors were controlled (OR s.2.08; 95 percent confidence interval, 1.23-1.51).
this appears to be driven primarily by differences in distant transfer rates (55% vs. 72% at 5 y, P.01);
the increase in quantitative load is highly significant in poor results.
in short, Meth-ctDNA may be a potential prognostic marker in the new auxiliary environment and, if validated, may identify patients with increased risk of distant metastasis.
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