{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:40:40Z","timestamp":1792604440053,"version":"4.5.0"},"reference-count":7,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess recurrence\u2010free survival (RFS) in patients with undetectable tumour\u2010informed circulating tumour DNA (ctDNA) before radical cystectomy (RC) and evaluate if those who converted from detectable to undetectable ctDNA status after RC have similar RFS outcomes as those with persistently undetectable ctDNA status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>Patients who underwent RC had prospectively and longitudinally collected tumour\u2010informed ctDNA analyses during 2021\u20132023. ctDNA status was informed from the pre\u2010RC specimen. The minimal residual disease (MRD) window was defined as the initial 90\u2009days after RC. RFS was evaluated using the Kaplan\u2013Meier method. Cox regression analysis was performed to find predictors of disease recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort included 135 patients with 647 ctDNA analyses. The median (interquartile range [IQR]) age was 71\u2009(63\u201377)\u2009years. Over a median (IQR) follow\u2010up of 11\u2009(7\u201318)\u2009months, 41 patients (30%) had a recurrence. Pre\u2010RC undetectable ctDNA status was found in 54 patients (40%). The RFS rates at 6, 12, and 21\u2009months were 98%, 93%, and 82%, respectively. Of 77 patients with undetectable ctDNA status at the MRD window available for conversion dynamics analysis, 43 had persistently undetectable ctDNA status (both at pre\u2010RC and MRD window) and 31 converted from pre\u2010RC detectable to MRD undetectable status (conversion group). The persistently undetectable group had significantly better RFS than the conversion group (log\u2010rank,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), with 12\u2010month RFS rates of 97% vs 51%, and 18\u2010month RFS rates of 88% vs 51%, respectively. On Cox multivariate analysis, only the conversion group status predicted disease recurrence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with undetectable pre\u2010RC ctDNA status have a favourable prognosis and may be candidates for treatment de\u2010escalation. Those with persistently undetectable ctDNA had superior RFS compared to the conversion group. Pre\u2010RC ctDNA status should be incorporated into trials examining ctDNA use in clinical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16556","type":"journal-article","created":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T22:49:15Z","timestamp":1729118955000},"page":"473-480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Undetectable pre\u2010radical cystectomy circulating tumour\n                    <scp>DNA<\/scp>\n                    status predicts improved oncological outcomes"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7946-7145","authenticated-orcid":false,"given":"Reuben","family":"Ben\u2010David","sequence":"first","affiliation":[{"name":"Department of Urology Icahn School of Medicine at Mount Sinai  New York NY 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