Circulating tumor DNA (ctDNA) testing provides significant prognostic information post-curative treatment for colorectal cancer, impacting patient management and surveillance strategies.

• Increased recurrence risk is observed in ctDNA-positive stage II-III patients compared to ctDNA-negative stage IV patients (p<0.0001).
• Employing multitimepoint ctDNA testing improves sensitivity for recurrence detection (79.9% vs 48.5%).
• Elevated usage of intensive second-line imaging occurred in patients with detectable ctDNA (p<0.0001).

Surgeons may consider incorporating ctDNA testing into their follow-up protocols for better risk stratification and earlier interventions.