Groundbreaking research reveals that radiotherapy, including precise SABR treatment, may leave behind undetected cancer cells despite showing clear scan results. The study, led by University of Chicago researchers, found that 40-86% of patients across various cancer types had residual disease after treatment. This hidden presence significantly impacts patient survival rates and cancer recurrence probability. The findings suggest a crucial need to revise current cancer treatment assessment methods beyond relying solely on imaging results.
March 24, 2025
Residual cancer linked to worse long-term outcomes: Scientists
"Residual cancer is identified on histology in
40 per cent of lung, 57-69 per cent of renal cell, 7.7-47.6 per cent of
prostate cancers" - Dr Muzamil Arshad, University of Chicago Medical
Center
Radiotherapy may leave behind
microscopic cancer even when scan images suggest the tumour is gone, and this
“residual disease” is more common than expected and is linked to worse
long-term outcomes, researchers have warned.
Key Points: Radiotherapy success on scans doesn't
guarantee complete cancer elimination
Dr Muzamil Arshad from the University of Chicago
Medical Center and colleagues highlighted this growing concern in cancer care,
in a new editorial published in Oncotarget journal.
Their perspective calls for a rethinking of how
treatment success is judged and how cancer is followed up after therapy.
Radiotherapy, especially a form known as
stereotactic ablative radiotherapy (SABR), is widely used to treat cancers in
the lung, liver, prostate, and other organs.
SABR delivers high-dose radiation with outstanding
precision and often shows excellent results on scans.
However, the authors highlighted that relying only
on imaging may not provide a complete picture.
Months or even years later, follow-up biopsies
frequently reveal cancer cells that scan imaging tests were unable to identify.
"Residual cancer is identified on histology in
40 per cent of lung, 57-69 per cent of renal cell, 7.7-47.6 per cent of
prostate and 0-86.7 per cent of hepatocellular carcinoma," said authors.
This gap between what scans show and what tissue
analysis finds can have serious consequences.
Studies across several cancer types have shown that
patients with residual disease -- even if small -- are more likely to
experience cancer recurrence and shorter survival.
This pattern holds true for rectal, cervical,
prostate, and liver cancers, among others. In some cases, not destroying the
tumour completely may allow it to spread to distant organs.
The authors pointed out that a complete response on
scan imaging does not necessarily indicate the complete disappearance of the
tumour.
The editorial encouraged the cancer care community
to look beyond the scan images. Residual cancer may remain even when imaging
looks clear, and recognising this hidden threat is key to improving long-term
outcomes.
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