HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Conditional survival after curative resection for extrahepatic cholangiocarcinoma: a comprehensive analysis of overall, recurrence-free, and relative survival.
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Choi Hea Lim, Kang Danbee, Han In Woon, Kim Hong Kwan, Kim Hyeong Seok, Shin Sang Hyun, Heo Jin Seok, Shin Dong Wook, Kim Hongbeom
Аннотация
BACKGROUND: Conditional survival offers dynamic, time-adjusted prognostic information but remains understudied in extrahepatic cholangiocarcinoma (EHCC). This study evaluated conditional overall survival (COS), conditional recurrence-free survival (CRFS), and conditional relative survival (CRS) after curative-intent resection for EHCC.
METHODS: We conducted a retrospective cohort study of 1266 patients who underwent curative-intent resection for EHCC (hilar, n = 424; common bile duct cancer [CBDC], n = 842) at a single institution between 2005 and 2019. Conditional 5-year COS, CRFS, and CRS were calculated annually using Kaplan-Meier methods and compared across demographic, clinical, and tumor-related subgroups.
RESULTS: At baseline, 5-year COS, CRFS, and CRS were 41.3 %, 29.3 %, and 47.9 %, respectively, improving to 51.9 %, 50.0 %, and 59.3 % at five years post-surgery. Stage III patients demonstrated the largest gains in COS (24.7 %-51.0 %) and CRFS (14.6 %-53.3 %). Younger patients and females consistently had superior outcomes, whereas obese patients and those receiving adjuvant therapy showed less favorable long-term trends. Conditional survival patterns were similar between hilar and CBDC.
CONCLUSION: Conditional survival in EHCC improves substantially with time survived, particularly among advanced-stage, younger, and female patients. However, nearly 40 % remain at risk of recurrence even after 5 recurrence-free years. Conditional estimates provide dynamic insights to guide counseling and surveillance.
METHODS: We conducted a retrospective cohort study of 1266 patients who underwent curative-intent resection for EHCC (hilar, n = 424; common bile duct cancer [CBDC], n = 842) at a single institution between 2005 and 2019. Conditional 5-year COS, CRFS, and CRS were calculated annually using Kaplan-Meier methods and compared across demographic, clinical, and tumor-related subgroups.
RESULTS: At baseline, 5-year COS, CRFS, and CRS were 41.3 %, 29.3 %, and 47.9 %, respectively, improving to 51.9 %, 50.0 %, and 59.3 % at five years post-surgery. Stage III patients demonstrated the largest gains in COS (24.7 %-51.0 %) and CRFS (14.6 %-53.3 %). Younger patients and females consistently had superior outcomes, whereas obese patients and those receiving adjuvant therapy showed less favorable long-term trends. Conditional survival patterns were similar between hilar and CBDC.
CONCLUSION: Conditional survival in EHCC improves substantially with time survived, particularly among advanced-stage, younger, and female patients. However, nearly 40 % remain at risk of recurrence even after 5 recurrence-free years. Conditional estimates provide dynamic insights to guide counseling and surveillance.