{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:14:39Z","timestamp":1787786079440,"version":"build-2784847793"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>DNA\u2010based liquid biopsies, including circulating tumor DNA (ctDNA) and cell\u2010free DNA (cfDNA), are emerging as minimally invasive biomarkers for monitoring surgical and postsurgical outcomes in gynecologic malignancies. These tools offer the potential to guide early intervention, refine risk stratification, and improve prognostic accuracy. This systematic review aimed to assess the clinical utility of DNA\u2010based liquid biopsies in evaluating recurrence, surgical success, and preoperative diagnosis in gynecologic cancers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted in accordance with PRISMA guidelines, covering studies published from 2017 to 2025. Literature searches were performed in PubMed, Scopus, and Web of Science. A total of 32 eligible observational studies involving 3210 patients with ovarian, endometrial, uterine, and other gynecologic malignancies were included. Study quality was assessed using the Newcastle\u2010Ottawa Scale (NOS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The studies showed a broad geographic and methodological diversity, with a median NOS score of 7. CtDNA and cfDNA demonstrated promise in three key areas: (1) Recurrence prediction\u2014postoperative ctDNA positivity was associated with higher relapse rates and reduced disease\u2010free survival; (2) Monitoring surgical outcomes and treatment response\u2014ctDNA dynamics more accurately reflected tumor burden than traditional markers like CA125; (3) Preoperative diagnostic support\u2014cfDNA methylation profiling and cfDNA\/CA125 models enhanced malignancy detection and risk stratification. Ovarian and endometrial cancers were most frequently studied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DNA\u2010based liquid biopsies show strong potential in perioperative care for gynecologic cancers. Their integration into clinical workflows could improve the detection of minimal residual disease and inform individualized surgical planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcla.70139","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T07:15:34Z","timestamp":1764659734000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["DNA\u2010Based Liquid Biopsy for Evaluating Surgical and Postsurgical Outcomes in Gynecologic Malignancies: A Systematic Review"],"prefix":"10.1002","volume":"40","author":[{"given":"Samaneh","family":"Yavari","sequence":"first","affiliation":[{"name":"School of Medicine Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1675-7195","authenticated-orcid":false,"given":"Sepide","family":"Javankiani","sequence":"additional","affiliation":[{"name":"General Surgery Department Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Foroozan","family":"Yarahmadi","sequence":"additional","affiliation":[{"name":"Islamic Azad University Tehran Medical Branch  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8607-346X","authenticated-orcid":false,"given":"Rojin","family":"Sarallah","sequence":"additional","affiliation":[{"name":"Islamic Azad University Tehran Medical Branch  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1083-9603","authenticated-orcid":false,"given":"Behandokht","family":"Rezaei","sequence":"additional","affiliation":[{"name":"School of Medicine Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Maroufi","sequence":"additional","affiliation":[{"name":"Department of Genetics, Faculty of Advanced Science and Technology, Tehran Medical Branch Islamic Azad University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Khabbazkar","family":"Amlashi","sequence":"additional","affiliation":[{"name":"Science and Research Branch Islamic Azad University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahshid","family":"Imankhan","sequence":"additional","affiliation":[{"name":"Islamic Azad University Tehran Medical Branch  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahnaz","family":"Marvi","sequence":"additional","affiliation":[{"name":"Arash Hospital Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Aslani","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arezou","family":"Soltanattar","sequence":"additional","affiliation":[{"name":"Islamic Azad University Yazd Ali ibn Abitaleb Medical School  Yazd Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Mohammadi","sequence":"additional","affiliation":[{"name":"Infertility Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0999-9871","authenticated-orcid":false,"given":"Alireza","family":"Azani","sequence":"additional","affiliation":[{"name":"Department of Medical Genetics, Faculty of Medicine Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pegah","family":"Kavousinia","sequence":"additional","affiliation":[{"name":"Department of Medical Biotechnology, Faculty of Medicine Birjand University of Medical Sciences  Birjand Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms19102877"},{"issue":"7","key":"e_1_2_11_3_1","article-title":"Advancements and Applications of Liquid Biopsies in Oncology: A Narrative Review","volume":"15","author":"Noor J.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416-022-01868-6"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-08-1564"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2024.01.003"},{"issue":"2","key":"e_1_2_11_7_1","first-page":"93","article-title":"Epidemiology and Risk Factors for Ovarian Cancer","volume":"22","author":"Ali A. 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