Fig 4.

Cell-free DNA monitoring enables earlier detection of distant metastasis recurrence. For eight patients (cohort 2), clinical events are denoted in gray and white. Dashed line indicates normal lactate dehydrogenase (LDH) level (≤ 190 U/L) and digital next-generation sequencing limit of detection (≥ 0.1%). Red arrows indicate surgical resection. (*) Local recurrence before distant metastasis or relapse. (†) Stop codon. DF, disease-free period of follow-up every 2 to 4 months; Distant mets: distant metastasis or relapse; Pre-op, American Joint Committee on Cancer stage III diagnosis before complete lymph node dissection; VAF, variant allele fraction.