Circulating tumor DNA can be an asset during surveillance in both patients undergoing watch and wait or surgery, with identification of recurrences earlier than traditional methods. Within our study, a positive circulating tumor DNA was suggestive of distant metastases rather than local recurrence, which may impact decision making in the way we manage these patients, particularly when considering salvage surgery. Large prospective studies are needed to determine the ideal implementation of circulating tumor DNA into surveillance protocols. (See Video Abstract).
Hulse et al. (Tue,) studied this question.