Elevated cell-free DNA measured by a simple assay is associated with increased rate of colorectal cancer relapse

David Czeiger, Gad Shaked, Gilbert Sebbag, Alex Vakhrushev, Anatoly Flomboym, Yotam Lior, Olga Belochitski, Samuel Ariad, Amos Douvdevani

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Objectives: For patients with early stage colorectal cancer (CRC), markers of high-risk relapse are needed. In a previous study on 38 randomly selected patients with CRC, we found good correlation between presurgery cell-free DNA (CFD) concentrations and standard prognostic factors. In the current study, we revisited the same patients at 5-year survival, aiming to evaluate the predictive power of presurgery CFD levels. Methods: We revisited 38 patients with CRC previously analyzed for 5-year outcome. CFD was measured using a simple fluorescent assay that we developed. Results: All recurrent patients and patients who had died of cancer within 5 years were shown to have presurgery CFD values above 800 ng/mL. The negative predictive value for cancer-related disease was 100%. Cox regression analysis for disease-free survival showed a hazard ratio of 6.03 (P=.003) for CFD, which was higher than the ratio of the disease stage, 1.9 (P=.006). The survival-free curve of stage I and II patients with elevated CFD was significantly different from patients with normal levels (P=.0136); 5 (41.7%) of 12 patients had died of cancer or had experienced a recurrence. Conclusions: CFD may possibly be a decisive criterion to identify patients with local disease who might benefit from adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)852-857
Number of pages6
JournalAmerican Journal of Clinical Pathology
Issue number6
StatePublished - 1 Jun 2016
Externally publishedYes


  • Biomarkers
  • Circulating cell-free DNA (CFD)
  • Colorectal cancer (CRC)
  • Hazard ratio
  • Prognosis
  • Treatment decisive marker

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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