Evidence map›Paper›PMID 42853501›Full record

ArticleAnnals of surgical oncology2026

Early Recurrence Limits Post-recurrence Therapy in Biliary Tract Cancer: A Rationale for Neoadjuvant Chemotherapy.

Daisaku Yamada, Hirofumi Akita, Yosuke Mukai, Kazuki Sasaki, Shinichiro Hasegawa, Yoshito Tomimaru, Takehiro Noda, Tadafumi Asaoka, Junzo Shimizu, Hidenori Takahashi and 2 more

Abstract read
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Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Daisaku YamadaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Hirofumi AkitaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan. hirofumi.akita@oici.jp.
Yosuke MukaiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Kazuki SasakiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Shinichiro HasegawaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Yoshito TomimaruDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Takehiro NodaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Tadafumi AsaokaDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Junzo ShimizuDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Hidenori TakahashiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Yuichiro DokiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.
Hidetoshi EguchiDepartment of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Yamadaoka, Suita, Osaka, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal treatment strategy for resectable biliary tract cancer (BTC) remains controversial, particularly in patients at high risk of early recurrence. We aimed to identify preoperative risk factors associated with impaired feasibility of post-recurrence treatment and to evaluate the impact of neoadjuvant chemotherapy (NAC) in high-risk patients. PATIENTS AND

methodsWe retrospectively analyzed patients with BTC who underwent upfront surgery (n = 323). Risk factors for intolerance (inability to continue systemic therapy for ≥ 3 months) after recurrence were evaluated, and high-risk patients were defined based on preoperative factors. In a separate cohort of 171 high-risk patients, outcomes were compared between patients who received NAC (n = 49) and those who underwent upfront surgery.

resultsIn the cohort of upfront surgery, clinical lymph node positivity (HR 1.96, P < 0.001) and elevated carbohydrate antigen 19-9 (CA19-9) levels (≥ 200 U/mL; HR 1.84, P < 0.001) were independent risk factors for recurrence-free survival (RFS). Among patients who developed recurrence, recurrence within 1 year was independently associated with intolerance after recurrence (OR 0.37, P = 0.003). Clinical lymph node positivity and/or elevated CA19-9 levels were independent risk factors for recurrence within 1 year (OR 3.27, P = 0.027). In the high-risk cohort, NAC was associated with significantly improved overall survival (OS) and RFS compared with upfront surgery (OS: HR 0.57, P = 0.022; RFS: HR 0.61, P = 0.016).

conclusionsPatients with resectable BTC with elevated CA19-9 or clinical lymph node positivity are at high risk of early recurrence and limited treatment feasibility after recurrence. NAC may improve outcomes in this population by delaying recurrence.

Indexed as

CA19-9Clinical lymph nodes positivityEarly recurrenceNeoadjuvant chemotherapyResectable BTCTreatment sustainability

Identifiers

PMID42853501

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.