Intensive Follow-Up Program and Oncological Outcomes of Biliary Tract Cancer Patients after Curative-Intent Surgery: A Twenty-Year Experience in a Single Tertiary Medical Center

Abstract

Aim. The aim of this research was to assess the impact of an intensive follow-up program on BTC patients who had received surgery with curative intent at a tertiary referral hospital. Methods. BTC patients were followed-up every three months during the first two years after their first surgery and every six months from the third to the fifth post-operative year. Results. A total of 278 BTC patients who received R0/R1 surgery were included. A total of 17.7% of patients underwent a second surgery following disease relapse, and none of these patients experienced additional disease relapse. Conclusions. An intensive follow-up after surgical resection may help in the early identification of disease relapse, leading to early treatment and prolonged survival in selected cases.

Clinico-Epidemiological Study of Pancreatic, Gall Bladder and Biliary Tract Cancers at Clinical Oncology Department Tanta University Hospitals

“…We discovered that 4 (11.4%) patients underwent surgery with the goal of curing them, that the projected median DFS of BTC patients was 5 months, and that 25% of these patients had a DFS of 6 months or more. In contrast, a retrospective analysis by Rizzo et al (Rizzo A. et al, 2022) found that between January 2000 and November 2020, the median DFS for R0 and R1 BTC patients who had surgery with the intention of curing the disease was 16.4 and 12.3 months, respectively. ( 663).…”

Post-operative Surveillance and Management of Intrahepatic Cholangiocarcinoma Using Circulating Tumor DNA: A Case Report

“…In fact, none of the 14 patients who received R0 repeat resection went on to experience disease recurrence. However, only 17% of patients were able to undergo surgery [ 5 ]. Other studies have also shown the benefit of repeat resection [ 6 - 7 ], and in conjunction with the evidence that adjuvant chemotherapy also improves outcomes, it becomes clear that appropriate surveillance guidelines are needed.…”

“…In comparison to current guidelines, serial ctDNA monitoring has been shown to predict CRC recurrence up to 16.5 months before CT imaging, with a median lead time of 8.7 and 9.8 months [ 16 , 17 ]. This length of time may be the difference in whether or not patients are able to undergo repeat resection and if R0 resection may be achieved, providing a chance at increased RFS [ 5 - 7 ]. For those patients who are not selected for repeat surgery, ctDNA has also been used to guide adjuvant chemotherapy use.…”

“…Global incidence of intrahepatic CCA specifically has increased dramatically in the last four decades, with poor overall survival (OS) and high rates of recurrence following surgical resection [2][3][4]. Although recurrence is high, there is evidence to suggest early repeat resection in select patients may lead to prolonged disease-free and OS, highlighting the need for appropriate follow-up [5][6][7]. However, there is scant data to support a specific schedule or modality for surveillance following surgery, and current guidelines are based on the schedule used in the phase III BILCAP trial [1,8].…”

Tumor immune microenvironment and the current immunotherapy of cholangiocarcinoma (Review)

“…While a minority of patients may qualify for surgical resection, the disease often exhibits a propensity for recurrence and metastasis even after radical surgery. Furthermore, the 5-year survival rate of patients remains dismally low, at <10%, accompanied by a staggering 1-year recurrence rate of ~60% (1)(2)(3). Additionally, CCA has exhibited resistance to systemic therapies, such as chemotherapy and targeted treatments.…”