Research Paper Volume 13, Issue 2 pp 2031—2048

Prognostic value of circulating tumor DNA in pancreatic cancer: a systematic review and meta-analysis

Zengli Fang1,2,3,4, *, , Qingcai Meng1,2,3,4, *, , Bo Zhang1,2,3,4, *, , Si Shi1,2,3,4, , Jiang Liu1,2,3,4, , Chen Liang1,2,3,4, , Jie Hua1,2,3,4, , Xianjun Yu1,2,3,4, , Jin Xu1,2,3,4, , Wei Wang1,2,3,4, ,

  • 1 Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, China
  • 2 Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • 3 Shanghai Pancreatic Cancer Institute, Shanghai 200032, China
  • 4 Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China
* Equal contribution

Received: August 12, 2020       Accepted: October 27, 2020       Published: December 9, 2020
How to Cite

Copyright: © 2020 Fang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Increasing evidence has revealed the potential correlation between circulating tumor DNA (ctDNA) and the prognosis of pancreatic cancer, but inconsistent findings have been reported. Therefore, a meta-analysis was performed to evaluate the prognostic value of ctDNA in pancreatic cancer. The Embase, MEDLINE, and Web of Science databases were searched for relevant articles published until April 2020. Articles reporting the correlation between ctDNA and the prognosis of pancreatic cancer were identified through database searches. The pooled hazard ratios (HRs) for prognostic data were calculated and analyzed using Stata software. A total of 2326 patients pooled from 25 eligible studies were included in the meta-analysis to evaluate the prognostic value of ctDNA in pancreatic cancer. Patients with mutations detected or high concentrations of ctDNA had a significantly poorer overall survival (OS) (univariate: HR = 2.54; 95% CI, 2.05-3.14; multivariate: HR = 2.07; 95% CI, 1.69-2.54) and progression-free survival (PFS) (univariate: HR = 2.18; 95% CI, 1.41-3.37; multivariate: HR = 2.20; 95% CI, 1.38-3.52). In conclusion, the present meta-analysis indicates that mutations detected or high concentrations of ctDNA are significant predictors of OS and PFS in patients with pancreatic cancer.


CIs: confidence intervals; ctDNA: circulating tumor DNA; ddPCR: droplet digital PCR; dPCR: digital PCR; HRs: hazard ratios; NGS: next-generation sequencing; NOS: Newcastle-Ottawa Scale; OS: overall survival; PC: pancreatic cancer; PCR: polymerase chain reaction; PFS: progression-free survival; PNA-clamp PCR: peptide nucleic acid-clamp PCR; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; RFLP-PCR: restriction fragment length polymorphism-PCR; RFS: recurrence-free survival.