Abstract
Peritoneal metastases from various abdominal cancer types are common and carry poor prognosis. The presence of peritoneal disease upstages cancer diagnosis and alters disease trajectory and treatment pathway in many cancer types. Therefore, accurate and timely detection of peritoneal disease is crucial. The current practice of diagnostic laparoscopy and peritoneal lavage cytology (PLC) in detecting peritoneal disease has variable sensitivity. The significant proportion of peritoneal recurrence seen during follow-up in patients where initial PLC was negative indicates the ongoing need for a better diagnostic tool for detecting clinically occult peritoneal disease, especially peritoneal micro-metastases. Advancement in liquid biopsy has allowed the development and use of peritoneal tumour DNA (ptDNA) as a cancer-specific biomarker within the peritoneum, and the presence of ptDNA may be a surrogate marker for early peritoneal metastases. A growing body of literature on ptDNA in different cancer types portends promising results. Here, we conduct a systematic review to evaluate the prognostic impact of ptDNA in various cancer types and discuss its potential future clinical applications, with a focus on gastrointestinal and gynaecological malignancies.
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Funding
Dr. David S Liu received research funding from the North Eastern Melbourne Integrated Cancer Service (Service Improvement Grant), Peter MacCallum Cancer Foundation (Discovery Partner Fellowship), Austin Medical Research Foundation (Grant-In-Aid), and the Royal Australasian College of Surgeons (Paul Mackay Bolton Grant for Cancer Research).
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ZA performed the systematic review search, drafted and revised the manuscript; SW performed the systematic review search and revised the manuscript; JT, NT, NC and DL supervised the systematic review search and revised the manuscript.
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Allan, Z., Witts, S., Tie, J. et al. The prognostic impact of peritoneal tumour DNA in gastrointestinal and gynaecological malignancies: a systematic review. Br J Cancer 129, 1717–1726 (2023). https://doi.org/10.1038/s41416-023-02424-6
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DOI: https://doi.org/10.1038/s41416-023-02424-6
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