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A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer

A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer
A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer

Background: there is currently no evidence to support structured use of imaging or biomarkers during follow-up of patients after curative resection of biliary tract cancer (BTC). Besides, the influence of early detection of recurrence and subsequent start of palliative chemotherapy on overall survival remains unknown. The aim of this study is to describe and compare the results of two follow-up strategies.

Methods: this retrospective multicenter cohort study compared patients from the Amsterdam UMC undergoing pragmatic clinical follow-up, to patients from the observational cohort of the BILCAP study undergoing structured follow-up. Primary outcome was overall survival.

Results: a total of 315 patients were included n=91 pragmatic, n=224 structured follow-up). At median follow-up of 56.9 months, 189 (60%) patients were diagnosed with recurrence. After recurrence, more patients received palliative (chemo) therapy in the structured group (43% vs 75%, P<0.001). Median overall survival was lower in the pragmatic group (27.7 vs 39.1 months, P=0.003). Median overall survival of patients who actually received chemotherapy was comparable (27.2 vs 27.7 months, P=0.574).

Conclusion: this study describes the results of two follow-up strategies. Although these groups are biased, it is noted that after pragmatic follow-up fewer patients received palliative chemotherapy but that those who actually received chemotherapy had similar overall survival compared to patients undergoing structured follow-up.

1365-182X
179-187
Nooijen, Lynn E.
447960af-e3f1-4485-ab2d-50062a4a204d
van der Snee, Lizzel
e6df91bf-21bd-4b69-9c62-8e3e9781ac6c
ten Haaft, Britte
054dd938-70c1-44b1-8f74-af1031f3aa90
Kazemier, Geert
33b7bfcd-f883-499d-85ab-6e6af1872a47
Klümpen, Heinz-Josef
937fb741-6b59-40dc-a025-2f387d099b7a
Bridgewater, John
a7c51f93-a80e-4b89-828f-34f477259d5c
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Erdmann, Joris
f6e2e7af-8344-4b3a-ad1f-d3502622e935
et al.
Nooijen, Lynn E.
447960af-e3f1-4485-ab2d-50062a4a204d
van der Snee, Lizzel
e6df91bf-21bd-4b69-9c62-8e3e9781ac6c
ten Haaft, Britte
054dd938-70c1-44b1-8f74-af1031f3aa90
Kazemier, Geert
33b7bfcd-f883-499d-85ab-6e6af1872a47
Klümpen, Heinz-Josef
937fb741-6b59-40dc-a025-2f387d099b7a
Bridgewater, John
a7c51f93-a80e-4b89-828f-34f477259d5c
Primrose, John
d85f3b28-24c6-475f-955b-ec457a3f9185
Erdmann, Joris
f6e2e7af-8344-4b3a-ad1f-d3502622e935

et al. (2024) A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer. HPB, 26 (2), 179-187. (doi:10.1016/j.hpb.2023.10.004).

Record type: Article

Abstract

Background: there is currently no evidence to support structured use of imaging or biomarkers during follow-up of patients after curative resection of biliary tract cancer (BTC). Besides, the influence of early detection of recurrence and subsequent start of palliative chemotherapy on overall survival remains unknown. The aim of this study is to describe and compare the results of two follow-up strategies.

Methods: this retrospective multicenter cohort study compared patients from the Amsterdam UMC undergoing pragmatic clinical follow-up, to patients from the observational cohort of the BILCAP study undergoing structured follow-up. Primary outcome was overall survival.

Results: a total of 315 patients were included n=91 pragmatic, n=224 structured follow-up). At median follow-up of 56.9 months, 189 (60%) patients were diagnosed with recurrence. After recurrence, more patients received palliative (chemo) therapy in the structured group (43% vs 75%, P<0.001). Median overall survival was lower in the pragmatic group (27.7 vs 39.1 months, P=0.003). Median overall survival of patients who actually received chemotherapy was comparable (27.2 vs 27.7 months, P=0.574).

Conclusion: this study describes the results of two follow-up strategies. Although these groups are biased, it is noted that after pragmatic follow-up fewer patients received palliative chemotherapy but that those who actually received chemotherapy had similar overall survival compared to patients undergoing structured follow-up.

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Accepted/In Press date: 1 October 2023
e-pub ahead of print date: 11 October 2023
Published date: February 2024

Identifiers

Local EPrints ID: 483241
URI: http://eprints.soton.ac.uk/id/eprint/483241
ISSN: 1365-182X
PURE UUID: 8e4ce430-fbfb-43fe-b706-4d452e042903
ORCID for John Primrose: ORCID iD orcid.org/0000-0002-2069-7605

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Date deposited: 26 Oct 2023 16:54
Last modified: 09 May 2024 01:33

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Contributors

Author: Lynn E. Nooijen
Author: Lizzel van der Snee
Author: Britte ten Haaft
Author: Geert Kazemier
Author: Heinz-Josef Klümpen
Author: John Bridgewater
Author: John Primrose ORCID iD
Author: Joris Erdmann
Corporate Author: et al.

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