{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:37:52Z","timestamp":1773139072595,"version":"3.50.1"},"reference-count":38,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Precis Oncol"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>\n                      This prospective study aimed to evaluate the prognostic significance of pretreatment\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      -mutant circulating tumor DNA (ctDNA) in predicting recurrence incidence and patterns in patients with colorectal liver metastasis (CRLM) undergoing radiofrequency ablation (RFA).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Seventy-eight patients with CRLM treated with curative-intent RFA were enrolled. Pretreatment plasma ctDNA was analyzed using droplet digital polymerase\u00a0chain\u00a0reaction for\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      mutations. Clinicopathologic data, recurrence patterns, and progression-free survival (PFS) were correlated with ctDNA and KRAS status. Transcriptomic profiling of tumor tissues was performed to explore biological mechanisms.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Pretreatment ctDNA was detected positive in 26.9% (21\/78) of patients. Patients who harbored\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      -mutant ctDNA exhibited significantly higher recurrence rates (71.4%\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      31.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004) and shorter median PFS (352 days\n                      <jats:italic toggle=\"yes\">v<\/jats:italic>\n                      not reached,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Multivariate Cox analysis confirmed that &gt;3 hepatic lesions (adjusted hazard ratio [HR], 7.66 [95% CI, 2.70 to 21.8],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and positive ctDNA status (adjusted HR, 3.20 [95% CI, 1.60 to 6.42],\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .001) were independent predictors of recurrence. Moreover, ctDNA-positive patients predominantly developed lung metastases (60%), while ctDNA-negative patients showed liver-dominant recurrence (61.1%). Transcriptomic analysis linked ctDNA positivity to epithelial-mesenchymal transition and DNA repair pathways, with elevated nicotinamide N-methyltransferase expression correlating with aggressive phenotypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>\n                      Pretreatment\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      -mutant ctDNA predicts higher recurrence risk and shows an association with lung-predominant metastasis in patients with CRLM after RFA. Integrating ctDNA and\n                      <jats:italic toggle=\"yes\">KRAS<\/jats:italic>\n                      profiling enhances risk stratification and supports personalized surveillance strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/po-25-00858","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:13:02Z","timestamp":1773087182000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Pretreatment KRAS-Mutant Circulating Tumor DNA Predicts Incidence and Patterns of Recurrence in Patients Undergoing Radiofrequency Ablation for Colorectal Liver Metastases: A Prospective Analysis"],"prefix":"10.1200","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-3158","authenticated-orcid":true,"given":"Ke","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1462-7549","authenticated-orcid":true,"given":"Cailun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daopeng","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"DongDong","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Forevergen Biosciences Co, Ltd, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingsen","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Forevergen Biosciences Co, Ltd, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minghui","family":"He","sequence":"additional","affiliation":[{"name":"Department of Forevergen Biosciences Co, Ltd, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhao","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Forevergen Biosciences Co, Ltd, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohua","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9761-9525","authenticated-orcid":true,"given":"Xiaoyan","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8225-5714","authenticated-orcid":true,"given":"Bowen","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Medical Ultrasonics, Institute of Diagnostic and Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"233","reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13010040"},{"key":"e_1_3_7_4_2","first-page":"e240029","article-title":"Colon cancer, version 3.2024, NCCN clinical practice guidelines in oncology","volume":"22","author":"Benson AB","year":"2024","unstructured":"Benson AB, Venook AP, Adam M, et al: Colon cancer, version 3.2024, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw 22:e240029, 2024","journal-title":"J Natl Compr Cancer Netw"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2022.10.003"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00660-0"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10163712"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142489"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12111851"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10162"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.14366\/usg.22208"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.02615"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308859"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1126\/scitranslmed.3007094"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02115-4"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/JS9.0000000000001236"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-023-10628-4"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-024-01865-0"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10555-020-09915-5"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28347"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.3109\/0284186X.2014.895036"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-012-0531-9"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-020-09449-8"},{"key":"e_1_3_7_24_2","doi-asserted-by":"crossref","unstructured":"Tang Z Li C Kang B et al. GEPIA: A web server for cancer and normal gene expression profiling and interactive analyses. Nucleic Acids Res 45:W98-W102 2017","DOI":"10.1093\/nar\/gkx247"},{"key":"e_1_3_7_25_2","first-page":"100081","article-title":"Revised strengthening the reporting of cohort, cross-sectional and case-control studies in surgery (STROCSS) guideline: An update for the age of artificial intelligence","volume":"10","author":"Agha RA","year":"2025","unstructured":"Agha RA, Mathew G, Rashid R, et al: Revised strengthening the reporting of cohort, cross-sectional and case-control studies in surgery (STROCSS) guideline: An update for the age of artificial intelligence. Premier J Sci 10:100081, 2025","journal-title":"Premier J Sci"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.15252\/embj.2022112559"},{"key":"e_1_3_7_27_2","doi-asserted-by":"publisher","DOI":"10.7150\/jca.90028"},{"key":"e_1_3_7_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-1063-5"},{"key":"e_1_3_7_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.71080"},{"key":"e_1_3_7_30_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-021-24109-5"},{"key":"e_1_3_7_31_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-019-0652-7"},{"key":"e_1_3_7_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.51700"},{"key":"e_1_3_7_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.05.011"},{"key":"e_1_3_7_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182a5025a"},{"key":"e_1_3_7_35_2","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.2014.619"},{"key":"e_1_3_7_36_2","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13219"},{"key":"e_1_3_7_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccell.2018.02.001"},{"key":"e_1_3_7_38_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13020346"},{"key":"e_1_3_7_39_2","volume-title":"Gene Set Enrichment Analysis","unstructured":"Gene Set Enrichment Analysis (GSEA): UC San Diego, Broad Institute, https:\/\/www.gsea-msigdb.org\/"}],"container-title":["JCO Precision Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/PO-25-00858","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T20:13:05Z","timestamp":1773087185000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/PO-25-00858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":38,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1200\/PO-25-00858"],"URL":"https:\/\/doi.org\/10.1200\/po-25-00858","relation":{},"ISSN":["2473-4284"],"issn-type":[{"value":"2473-4284","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-02","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e2500858"}}