Expert Consensus on Clinical Application of Molecular Residual Disease Detection in Resectable Lung Cancer (2026 Edition)

Detection of molecular residual disease (MRD) based on circulating tumor DNA holds significant application value for prognostic assessment and recurrence monitoring in resectable lung cancer. However, current practices lack standardized guidelines regarding core aspects such as target populations, technical approaches, timing of monitoring, and adaptive treatment strategies. To address this, the Chinese Thoracic Oncology Group (CTONG) YOUNG established a "Working Group on Expert Consensus for Molecular Residual Disease in Resectable Lung Cancer". Based on a systematic review of the latest international advancements and objective evidence-based medical data, the group formulated the Expert Consensus on Clinical Application of Molecular Residual Disease Detection in Resectable Lung Cancer (2026 Edition). This consensus focuses on a systematic and in-depth discussion of key issues, including the selection of target populations for MRD detection, optimization of technical detection pathways, determination of perioperative and postoperative longitudinal follow-up time points, and the clinical value of MRD status in guiding escalation or de-escalation strategies for both treatment-naïve patients and those receiving neoadjuvant therapy. In addition, the consensus specifies the essential components for standardizing MRD detection reports. The aim is to provide an objective scientific basis and decision-making reference for thoracic surgeons and oncologists in clinical practice, thereby advancing the field of resectable lung cancer toward a new era of individualized precision management.