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Esophageal cancer sheds little circulating tumor DNA (ctDNA), leading first-generation MRD assays to miss occult disease. Applying ultrasensitive MAESTRO assays to 331 plasma samples from 36 patients treated with curative intent, a recent article found 60% of ctDNA-positive samples were <100 ppm, and every recurrence preceded by postoperative ctDNA detection.
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Hidalgo et al. (2026) studied this question.
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