Purpose: Circulating tumor DNA (ctDNA) is a noninvasive biomarker for tumor burden. Blood-based assays utilizing ctDNA copy number aberrations and fragment size show promise in hepatocellular carcinoma (HCC), but their prognostic value is unclear. This study evaluated the clinical relevance of a ctDNA-based score in predicting HCC prognosis. Patients and Methods: Clinical and ctDNA data from 93 HCC patients were analyzed. Patients were stratified by a predefined ctDNA score cutoff. Group comparisons used chi-square tests. Kaplan-Meier and multivariate Cox regression analyses assessed prognostic relevance. Results: Elevated ctDNA scores were associated with aggressive features: higher AFP and PIVKA-II levels, larger tumor size, macrovascular invasion, and advanced TNM stage (all P 0.61199 had significantly worse overall survival (OS). Univariate analysis identified 19 OS-associated variables, including inflammatory markers, biochemical indices, and tumor burden parameters. Multivariate analysis confirmed ctDNA score > 0.61199 (HR = 6.99, 95% CI 2.34– 20.85, P 400 ng/mL (HR = 0.28, 95% CI 0.13– 0.61, P = 0.001), ALB 3 (HR = 3.85, 95% CI 1.58– 9.40, P = 0.003) as independent prognostic determinants. Conclusion: Elevated ctDNA scores are strongly associated with adverse outcomes in HCC, highlighting their potential as a noninvasive prognostic biomarker. Integrating ctDNA assessment could improve risk stratification and treatment decisions, warranting validation in prospective studies. Keywords: circulating tumor DNA, hepatocellular carcinoma, prognosis, copy number aberrations, fragment size
Ma et al. (Sun,) studied this question.
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