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

Nooijen, Lynn E; van der Snee, Lizzel; Ten Haaft, Britte; Kazemier, Geert; Klümpen, Heinz-Josef; Bridgewater, John; Primrose, John; (2023) A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer. HPB 10.1016/j.hpb.2023.10.004. (In press). Green open access

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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.

Type: Article
Title: A critical appraisal of the potential benefit of post-operative structured follow-up after resection for biliary tract cancer
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.hpb.2023.10.004
Publisher version: https://doi.org/10.1016/j.hpb.2023.10.004
Language: English
Additional information: © 2023 The Authors. Published by Elsevier Ltd on behalf of International Hepato-Pancreato-Biliary Association Inc. under a Creative Commons license (http://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Haematology
URI: https://discovery.ucl.ac.uk/id/eprint/10180842
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