Dr Kozo Kataoka speaks to ecancer about the ctDNA status and adjuvant chemotherapy after resection of colorectal liver metastases. The study found that the role of circulating tumour DNA defined molecular residual disease in guiding treatment decisions after resection of colorectal liver metastases.

Drawing from the prospective CIRCULATE Japan GALAXY study, the analysis evaluates whether ctDNA status can predict survival outcomes and identify patients most likely to benefit from adjuvant chemotherapy.

Dr Kataoka says that the findings show that patients who are ctDNA positive shortly after surgery have significantly worse disease free and overall survival, confirming molecular residual disease as a powerful prognostic marker. Importantly, adjuvant chemotherapy was associated with substantial survival improvements in these MRD positive patients, suggesting a clear role for treatment intensification in this high risk group.

In contrast, patients who were ctDNA negative demonstrated favorable long term outcomes and did not derive meaningful benefit from adjuvant chemotherapy, raising important considerations about avoiding overtreatment.

Overall, Dr Kataoka focuses on how ctDNA guided strategies could transform postoperative management in colorectal liver metastases, enabling more precise, risk adapted treatment approaches and supporting ongoing efforts to validate biomarker driven care.