Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 28, 2025; 31(32): 109383
Published online Aug 28, 2025. doi: 10.3748/wjg.v31.i32.109383
Role of preoperative circulating tumor DNA in predicting occult metastases in resectable and borderline resectable pancreatic ductal adenocarcinoma
Takeshi Murakami, Masafumi Imamura, Yasutoshi Kimura, Kazunori Watanabe, Yoshihito Shinohara, Toru Nakamura, Siew-Kee Low, Masayo Motoya, Yujiro Kawakami, Yoshiharu Masaki, Tomohiro Kubo, Makoto Yoshida, Eiji Yoshida, Toru Kato, Kazuharu Kukita, Daisuke Kyuno, Ichiro Takemasa
Takeshi Murakami, Masafumi Imamura, Yasutoshi Kimura, Eiji Yoshida, Toru Kato, Kazuharu Kukita, Daisuke Kyuno, Ichiro Takemasa, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, Sapporo 060-0061, Hokkaidō, Japan
Kazunori Watanabe, Yoshihito Shinohara, Toru Nakamura, Department of Gastroenterological Surgery II, Hokkaido University Faculty of Medicine, Sapporo 060-0808, Hokkaidō, Japan
Kazunori Watanabe, Yoshihito Shinohara, Siew-Kee Low, Cancer Precision Medicine Center, Japanese Foundation for Cancer Research, Ariake 135-8550, Tokyo, Japan
Masayo Motoya, Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo 006-0811, Hokkaidō, Japan
Yujiro Kawakami, Yoshiharu Masaki, Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo 060-0061, Hokkaidō, Japan
Tomohiro Kubo, Makoto Yoshida, Department of Medical Oncology, Sapporo Medical University School of Medicine, Sapporo 060-0061, Hokkaidō, Japan
Author contributions: Murakami T, Imamura M, Kimura Y, and Nakamura T designed the study; Murakami T, Imamura M, Kawakami Y, Nakamura T, Motoya M, Masaki Y, Kubo T, Yoshida M, Yoshida E, Kato T, and Kukita K collected and assessed clinical data; Watanabe K, Shinohara Y, and Low SK performed circulating tumor DNA analysis; Murakami T wrote the first draft of the manuscript; Imamura M, Kimura Y, and Kyuno D revised the manuscript; Kimura Y and Takemasa I supervised the study; All authors reviewed the results and approved the final version of the manuscript.
Supported by the Council for Science, Technology, and Innovation (CSTI) Cross-Ministerial Strategic Innovation Promotion Program (SIP) “Innovative AI Hospital System” (National Institute of Biomedical Innovation, Health and Nutrition), No. SIPAIH18C03; and the Japan Society for the Promotion of Science (JSPS) KAKENHI, No. JP19K09179 and No. JP23K08158.
Institutional review board statement: This study was approved by the Institutional Review Board of Sapporo Medical University (No. 302-240), Hokkaido University (No. 18-053), and the Japanese Foundation for Cancer Research (No. 2018-1016 and No. 2020-1150).
Clinical trial registration statement: This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (registration No. UMIN 000054546). Details are available at https://center6.umin.ac.jp/cgi-bin/ctr/ctr_view_reg.cgi?recptno=R000062319.
Informed consent statement: All eligible patients provided written informed consent before participation.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data generated in this study are available upon request from the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Masafumi Imamura, MD, PhD, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo 060-0061, Hokkaidō, Japan. imamura@sapmed.ac.jp
Received: May 9, 2025
Revised: June 6, 2025
Accepted: August 1, 2025
Published online: August 28, 2025
Processing time: 110 Days and 13 Hours
Core Tip

Core Tip: Circulating tumor DNA (ctDNA) levels, when used alongside conventional biomarkers, may offer valuable insights for developing individualized treatment strategies in pancreatic ductal adenocarcinoma. These include determining the optimal regimen and duration of neoadjuvant therapy. In addition, ctDNA may help identify the most appropriate timing for surgery, thereby enabling more precise treatment decisions and potentially contributing to improved clinical outcomes and long-term prognosis.